Living donor kidney transplantation is the best treatment for selected patients with end-stage kidney disease (ESKD). However, living kidney donation is not without medical consequences and risks. As in the general population, long-term health risks in donors vary by race, sex, and age. Post-donation sequelae have been primarily studied in national registry data linked to mortality and ESKD data, with comparison groups of “healthy non-donor controls” contrived from unrelated cohort studies. One notable risk to donors is developing ESKD, the very condition their donation sought to fix. Our team has been working for more than a decade to understand risk factors for kidney living donors. Several environmental, lifestyle, and genetic risk factors have been demonstrated among the general population, and the fact that biological relationship to the recipient is a risk factor for ESKD in donors suggests a possible gene-mediated risk in living donors. LKDs, however, are biologically distinct from the general population and donor risk factors for ESKD might or might not align with those in the general population. On the one hand, loss of one kidney and hyperfiltration of the existing kidney may increase the impact of genetic or other risk factors; on the other hand, that donors are healthy at the time of donation may mean that some risk factors have decreased or no impact. Unfortunately, the impact of many genetic, clinical, social, and lifestyle risk factors that may confer added risk of ESKD in kidney donors is unknown, forcing donors to make a life-altering decision with inadequate information. We aim to improve the counseling and selection of living donors by developing tools for tailored risk prediction according to donor characteristics. However, this cannot be done prospectively because it takes so long for living donors to develop ESKD. This work will prepare us to use an innovative case-cohort study design to address this gap. We propose to use qualitative research to inform recruitment strategies and messaging to maximize recruitment of black donors. We will conduct semi structured interviews with 30 living kidney donors to understand willingness to participate in a case cohort study and undergo genetic testing and counseling for research purposes. We will also gather their perspectives to inform our recruitment strategy. We will also conduct community engagement activities via a community advisory board (Living Kidney Donor Research Advisory Council) to build trust and inform future research approaches. In this process, we will also obtain feedback and recommendations for how to best produce videos to be used for recruitment purposes.