*Purpose: To determine the socio-demographic characteristics of potential living kidney donors, donor motivation, incidental findings on clinical evaluation and some identified factors that precluded eventual kidney donation.

*Methods: A retrospective review of clinical data of potential living donors who presented for pre-donation evaluation over a period of 20 months (August 2017-March 2019) in three kidney care centres in Southeast Nigeria. Age, gender, occupation, relationship to prospective recipient, motivation behind donation, clinical findings and exclusion criteria were collated.

*Results: Information for one hundred and twenty eight (128) potential living donors was retrieved. Mean age was 26±6.5 years. There were 120 males and 8 females with M:F ratio of 15:2. Majority were unskilled workers (59%) and unrelated to prospective recipients (68.7%). Among those related to the patients (31.3%), there were more second degree relatives (18.8%) than first degree relatives (12.5%). Ninety six (75%) of the prospective recipients received blood transfusion during haemodialysis. The motivations behind donation were fear of losing a loved one to death (81.3%), altruism (12.5%) and financial gain (6.2%). Some incidental findings identified on clinical evaluation included proteinuria (15.6%), hypertension (12.4%), bradycardia (6.2%), abnormal glucose tolerance (3.1%), cardiomegally (3.1%), bacteriuria (3.1%), renal cysts (3.1%). Some exclusion criteria findings included immunological incompatibility (31.3%), proteinuria (15.6%), hypertension (12.4%), financial motivation (6.2%) and abnormal glucose tolerance (3.1%), abnormal cardiac tests (3.1%). Presence of donor specific antibody (58%), positive lymphocyte cross match (19%) and more than 3/6 HLA mismatches were the incompatible immunological factors.

*Conclusions: Immunological incompatibility was the leading cause of failure to donate a kidney with presence of donor specific antibody been the predominant factor. Pre-sensitization with multiple blood transfusions may be the culprit and measures to avoid blood transfusion will be invaluable for a transplant program in a resource-poor setting like ours.

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