Living donation is an option for meeting the needs of patients with end-stage renal disease. We surveyed kidney transplant professionals to understand their attitudes, opinions, and practices regarding living donation and to generate a rough estimate of the national potential for living related kidney donation. Although this sample of health practitioners expressed strong support for living donation, their actual professional practice does not necessarily reflect such support. Given the disparity between support and practice, we recommend that leaders in the kidney transplant community focus on several concrete objectives to optimize living donation: estimate the underlying potential for living donation; identify and implement best demonstrated practices for making the living donation request; explore and respond to the ethical issues that surround living donation; and address the needs of both donors and recipients.