Introduction: This study aimed to explore the knowledge level, preferences, and beliefs of Black American (BA) potential living kidney donors regarding living kidney donation and genetic testing for the APOL1 allele.  
Methods: Participants (n=742) completed a 21-question online survey administered to a Qualtrics panel. The survey assessed knowledge of kidney donation and genetic testing, as well as attitudes and beliefs regarding living kidney donation, genetic testing, and trust of health care institutions. Univariate and bivariate statistics were used to characterize the sample and study variables as well as to test for associations between variables.  
Results: All participants identified as BA, with 5.4% (n = 40) identifying as Afro-Latinx. 65.9% (n = 489) of the sample was female, with a mean age of 38 years and a standard deviation of 12.1. Most participants had equivalent to a high school education or greater (n = 661, 89.1%), and an annual household income of < $75,000 (n = 558, 75.2%). Nearly all participants (n = 715, 96.4%) reported awareness of organ donation, and 37.2% were registered organ donors (n = 246). Higher knowledge levels of kidney transplantation were observed among participants with advanced degrees (Mean (M) = 4.5, Standard Deviation [SD] = 2.2), and private health insurance (4.1, (1.9)). Participants with no health insurance (3.5 (2)), a high school education or less (3.6, (2)), and an annual household income < $25,000 (3.5, (2)), exhibited lower knowledge scores regarding kidney transplantation. More favorable attitudes toward kidney transplantation were observed among females (21.3 (4.3)), and participants with advanced education (22.1 (3.8)). Lower favorability toward kidney transplantation was observed among those with lower educational attainment (20.6 (4.4)), no health insurance (19.2 (4.4)), and < $25,000 annual household income (20.3 (4.3)). Having a college degree (35.5 (6.9), an annual household income of $100,000+ (36.3 (7)), and health insurance coverage (35 (7)) were each associated with higher favorability toward genetic testing. Lower favorability toward genetic testing was identified among participants with lower education attainment (34.9 (7.5)), no health insurance (33.5 (6.7)), and < $25,000 annual household income (34.2 (6.8)).
Conclusion: These findings suggest thtat low-resourced Black Americans have lower levels of knowledge adn acceptabiltiy of live donor kidney transplantation and genetic testing for the APOL1 allele. Efforts to increase rates of living donation among this population must begin with culturally and linguistically appropriate education.