We report on living kidney donation from a prison inmate on death row. Thirty years ago we were involved in an unusual set of circumstances that we assumed would never arise again. That assumption is incorrect as a current death row inmate wishes to be a living kidney donor and we speak now to describe the lessons learned and to help others. This report is focused on living donation, excluding posthumous donation, and discusses the ethical, legal, medical and logistic considerations underpinning prisoner donation for both the general prison population and death row inmates. We believe inmates on death row can be considered as living organ donors and the ethical, logistic and medical hurdles surmounted to enable donation. This experience with death row inmates should serve to encourage donation from the general prison population.