[ad_1]
September 09, 2025
3 min read
Key takeaways:
- Of 9,922 U.S. adults surveyed, 87.4% said they would donate an organ to a family member while living.
- Knowledge and belief in fairness of the system were associated with willingness to be a living donor.
Adults with greater knowledge and trust in the organ donation system were more likely to report willingness to be a living donor for a family member, according to an analysis of national survey data.
“Willingness to become a living donor is shaped by what people know and how much they trust the fairness of the transplant system,” Lauren D. Nephew, MD, MA, MSCE, assistant professor of medicine in the division of gastroenterology and hepatology at Indiana University School of Medicine in Indianapolis, told Healio. “Increasing accurate knowledge and strengthening transparency and equity in allocation appear central to expanding the living donor pool.”
Lauren D. Nephew
Nephew and colleagues analyzed data from the 2019 National Survey of Organ Donation Attitudes and Practices, administered by phone and online by HHS, Health Resources and Services Administration and the division of transplantation within the Health Systems Bureau. Of the 9,922 adults who responded to the question, “How likely are you to donate an organ to a family member while living?”, 53.2% were women; 67.1% identified as white, 10.6% as Black and 11% as Hispanic or Latino; 78.9% reported more than a high school education; and 86.1% had health insurance.
Of the cohort, 87.4% said they would be “very likely” or “somewhat likely” to donate an organ to a family member while living.
Knowledge, trust, religiosity
Knowledge of organ transplantation was higher among respondents willing to donate vs. those not willing (OR = 1.62; 95% CI, 1.49-1.77). Among willing vs. unwilling respondents, significantly more were aware that kidneys (93.8% vs. 70.5%), parts of livers (82.2% vs. 58.3%) and parts of lungs (60.3% vs. 45%) could be donated while living.
“I think people who understand which organs can be donated while living, and the stakes for patients, likely feel less fearful, which raises stated willingness,” Nephew said.
In contrast, perception of inequality in the transplant system decreased willingness (OR = 0.85; 95% CI, 0.78-0.92). Significantly more of those willing vs. unwilling to donate agreed with the statement, “The U.S. transplant system uses a fair approach to distribute organs to patients” (74.7% vs. 49%%).
“When people believe allocation is transparent and fair, donation feels like an act that will benefit those in true need rather than those with greater wealth or power,” Nephew said. “Long-standing structural inequities and medical mistrust can depress willingness.”
In addition, religiosity was prominent among those willing to donate with 44.1% reporting religious beliefs were “very important” to them vs. 32.7% of those not willing.
Demographic differences
More women said they were willing to donate than men: Women made up 54.5% of those willing to donate and 44.2% of those not willing (women vs. men willing to donate, OR = 1.49; 95% CI, 1.23-1.81). Significantly more white respondents said they would vs. would not donate, whereas significantly fewer Black and Asian respondents said they would vs. would not be donors, according to the researchers.
“Gendered social norms around caregiving, prior exposure to health systems, and different patterns of health literacy may play a role in why white women were more likely to donate than other groups,” Nephew said. “This likely also reflects unequal access to high-quality information, differential experiences with health care, and exposure to historical and contemporary bias that erode trust.”
Increasing living donation
Willingness to donate did not differ according to insurance status.
“This suggests that attitudes about living donation are more closely tied to knowledge and perceived fairness than to payer status, although insurance still matters for real-world access to evaluation,” Nephew said. “However, it is actually the recipient’s insurance that covers the cost of living donation. The actual cost of the medical procedure and follow-up may not be a barrier for many donors, but the inability to take off from work and lost wages, along with other social barriers [may be].”
Policymakers seeking ways to increase living organ donation must “target both attitude change and removal of practical barriers,” Nephew said.
Strategies should include:
- requiring plain language education for all transplant evaluations;
- creating transparency to build trust in fairness of the system;
- highlighting diverse experiences with TV and social media campaigns; and
- reducing donor burden with paid leave, job protection, travel and childcare support, among others.
“Building trust requires consistent transparency and reporting that is accessible and meaningful to communities most affected by organ failure,” Nephew said.
For more information:
Lauren D. Nephew, MD, MA, MSCE, can be reached at lnephew@iu.edu.
Sources/Disclosures
Collapse
Healio interviews
Disclosures:
Nephew reports consulting for Novo Nordisk outside the submitted work. Please see the study for all other authors’ relevant financial disclosures.
[ad_2]
Source link
