*Purpose: There is incongruity between the transplant waiting list and the number of deceased donors available, therefore there is an enduring challenge to increase the number of living donors. On the other hand, there are nearly 60 intriguing living donors who donated more than one solid organ so far in the US. 17 of these donors donated at our center. We looked at those patients’ charts and tried to learn how they made that decision.

*Methods: Using our divisional database a retrospective chart review was done on all donors who donated a liver and a kidney. Data regarding reasons for donation, altruism, and complications were abstracted.

*Results: 17 patients donated two organs, a liver and a kidney, at different times. Nine of the patients (53%) were males. Six (35%) were residents of Pennsylvania and the others came from different states. Eleven (65%) patients identified themselves as believers and six (35%) did not associate themselves with any religion. Nine of the patients (52%) were either married or had a long term relationship. Nine (53%) had children, and 15 (88%) had at least one parent alive. 13 (76%) had a Bachelor degree or higher. 14 (83%) consumed alcohol either socially or moderately and three did not. Four of our patients (24%) had depression, one of whom with suicidal ideation. The four were diagnosed, received pharmacologic treatment and cleared by our psychiatrists for the surgeries prior to donation. Eleven of the patients (65%) donated the kidney before the liver. The average age at the first donation was 39 years and the average time between both surgeries was 3.8 years. Twelve patients (71%) were altruistic donors at the first donation, and three of the five non-altruistic donors in the first donation became altruistic in the second. Some of the reasons for donating were “after losing his son to brain cancer”, “good experience with his previous kidney donation”, “after knowing that one can do it again”. Major complications happened in three patients. One of them was an intraabdominal abscess that happened after the second donation which was a kidney. The second underwent incisional hernia repair after the first donation which was a liver and after the second which was a kidney. The third patient had an exploratory laparotomy for obstruction four days after his second donation which was a liver. Adhesion bands from the previous kidney trocar sites were the culprit. All 17 donors are still alive and had an otherwise uncomplicated postoperative course.

*Conclusions: Factors like previous good experience in donation and the knowledge that it can be done helped in the decision making for some donors to donate for the second time. More research is needed on this topic to help assess the safety of dual donation and to help advocate additional donating.

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