*Purpose: Imminent death donation (IDD) describes non-fatal recovery of a living donor organ (a single kidney or partial liver) prior to a planned withdrawal of life support. The UNOS Ethics Committee has determined that IDD may be ethically appropriate; however, some critics have raised concerns that IDD may negatively impact public trust. The aim of this study is to preliminarily assess public attitude towards imminent death donation and inform the development of a national questionnaire in an effort to determine if IDD can be employed to meet the unmet need for high-quality organs.

*Methods: Three 60 minute phone interviews were conducted. Families were invited to participate through our region’s organ procurement organization. Two families were decision-makers of deceased donors and one family was the decision maker for a potential imminent death donor that did not occur. Participants were asked to (1) discuss and characterize general donor terminology, especially specific to IDD; (2) give general opinions about the process and ethics of IDD; and (3) review the clinical vignette planned for future surveys to assess cultural perceptions of the practice as well as evaluate the potential of IDD as a modality of donation.

*Results: These qualitative interviews of a very particular subset of the population illustrate that people with an understanding of organ donation are in favor of IDD after hearing a case scenario explaining the concept. Their rationale behind preliminary support for IDD was the same as their initial decision to participate in the donation process. All families iterated that donation is justified if something good is able to come from tragedy. Their major concerns with IDD were the potential surgical complications, like pain or hastened death. With the goal of creating a mass survey to assess for public attitudes, these interviews also helped gauge participant understanding of specific medical terminology to pinpoint the ideal language to discuss IDD in a coherent, succinct and sensitive manner.

*Conclusions: The UNOS Ethics Committee has concluded that IDD is a potentially viable and ethical option for organ procurement; however, there are concerns about how IDD affects public opinion and trust. These interviews preliminarily validated our current hypotheses that IDD is actually supported by those who have already gone through the donation process, and suggests public trust would not be as meaningful of an issue as purported. Using this highly selected subset of people helped inform a national survey that will be administered on a large scale to build upon the public opinion regarding implementation of IDD.

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