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In Ontario, the organs of deceased donors are usually allocated to those recipients who are ranked highest on the province s waiting list for transplant surgery. However, on rare occasion, a donor, or the donor s family, will request that an organ be given to a designated recipient or designated group of recipients. The ethical acceptability of these so-called directed donations of organs from deceased donors is debated in the transplant literature. The purpose of this study was to elicit the views of a group of transplant professionals in Ontario on the question, Under what circumstances, if any, should a donor or the donor s family be allowed to choose the recipient of the organ? Qualitative in-depth interviews were conducted with 14 Ontario transplant professionals from a range of clinical disciplines. An analysis of these interviews revealed several practical and ethical considerations that the transplant professionals believed to be important in assessing the acceptability of directed donations.