PURPOSE: To determine the psychosocial effects of donor nephrectomy on a sample of Canadian donors. MATERIALS AND METHODS: Patients donating one of their kidneys for transplantation at the Toronto Hospital between 1991-1996 were asked to complete a 170-item questionnaire designed to assess their psychosocial well-being and the impact of renal donation on various aspects of their lives. Of the 153 donors contacted, 104 (68.0%) have responded to date. RESULTS: Less than 5% of donors complained of renal donation severely affecting any aspect of their life. Most donors (84%) were able to perform their normal daily activities within 12 weeks of nephrectomy, and 75% had recovered their pre-donation level of work function by this time. Almost one third of donors lost wages because of their donation, and half incurred significant transportation costs. Very few donors (< 10%) complained of other costs. Almost 90% of donors felt that donating a kidney had positively impacted their relationship with the recipient, and donors felt that their relationships with the recipient were significantly more positive at follow-up (p<.003). CONCLUSIONS: Donating a kidney results in a moderate psychosocial impact on the donor and appears to strengthen the bond between donor and recipient. Recovery times to daily activities and work may be longer than anticipated in a large proportion of donors.