*Purpose: To identify financial factors that affect living kidney donors’ attitudes and progress towards donation, we conducted a survey of 2576 potential living donors [48% White, 21% Hispanic, 16% Black, 9% Asian] assessing if any socioeconomic factors, possibility of incurring donation-related costs, or ability to take time off work would: (1) deter potential donors from taking donation steps, and (2) be associated with a greater preference not to be chosen as a donor, and whether this differed by race.

*Methods: We surveyed potential donors from five transplant centers with no clear medical contraindications to donation, 37% of whom had incomes <$50,000.

*Results: Compared to White donors, more non-White donors had incomes below $50,000 (51% vs. 23%), no insurance (17% vs. 6%), and no access to a car (8% vs. 3%) (P < 0.001). Some reported that having to take time off work (18%) or incurring donation related costs (16%) would deter them from donation, with non-white donors (20% time off; 18% costs) reporting these more commonly than white donors (16% time off; 14% costs). A greater proportion of the donors who reported time off and costs as deterrents also wished their recipient would receive a kidney from someone other than them (time off: 22% vs. 6%, cost: 20% vs. 7%; P < 0.001). White donors completed an average of 6.4 steps toward donation compared to 5.7 for non-White donors (Table, p<0.001). Donors who reported a financial challenge such as lack of health insurance, lack of access to a car, or cost burden completed fewer steps towards transplant (Table).

*Conclusions: Greater financial challenges were negatively associated with motivation and actions towards donation. These factors are more prevalent in non-White donors. Further assessment is necessary to determine if these challenges affect who actually donated.

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