*Purpose: In the setting of ongoing methods to increase living donation, including novel methods that harness the power of social media, it is imperative that transplant centers ensure potential living donors are not coerced or pressured to donate. To address this, we created and utilized a novel, 6-question pressure assessment for all potential living kidney donors (PLDs) evaluated at our center.

*Methods: We studied1962 PLDs who initiated donor evaluation between 11/2013 and 6/2018. We calculated a pressure score for each PLD by averaging the pressure reported on the 5 Likert scale pressure assessment questions (1=least pressure, 5=most pressure). The final question assessed motivation for donation.

*Results: Among the PLDs who completed a pressure assessment, the median age was 43 (IQR = 33-55), 38.0% were male, 32.2% were non-white/Caucasian, 47.3% were biologically related to their intended recipient, and 85.1% listed “I wanted to help my recipient” as the most important reason for donating (Table 1). The majority of PLDs did not feel pressured (Pressure score of 1 in 76.2% of PLDs)(Figure 1). Pressure to donate described by a pressure score greater than 1 was more often reported among male (_1.161.45_1.81, p<0.01), non-white/Caucasian (_1.021.29_1.64, p=0.03), and PLDs related to their intended recipient (_1.421.78_2.23, p<0.001) (Table 2).

*Conclusions: Most PLDs do not feel pressure when making the decision to donate. Interestingly, those related to their intended recipient felt almost twice as much pressure as those who were unrelated. This novel pressure assessment offers a way to identify pressured donor candidates early in the evaluation process, and our findings indicate that seeking unrelated donors through social media might perhaps be less pressuring than direct interactions with related donors.

« Back to 2019 American Transplant Congress