Naibauer Sydney, Branagan William T, Lehto Stephanie, Reynolds Nicole, Mikulich-Gilbertson Susan, Page Chloe E, Davis Rachel A
Department of Psychiatry, University of Colorado Anschutz Medical Center, Aurora, CO, United States.
Colorado Center for Transplantation Care, Research and Education (CCTCARE), University of Colorado Anschutz Medical Center, Aurora, CO, United States.
Front Public Health. 2025 Mar 26;13:1552393. doi: 10.3389/fpubh.2025.1552393. eCollection 2025.
Only 18% of kidneys and livers transplanted in the United States come from living donors, and increasing rates of living organ donation could help decrease the critical organ deficit. Non-directed living donation is even less common, with only 1.4% of kidney and liver transplants coming from anonymous donors (1). This study aimed to determine which factors are considered more motivating and more discouraging to living organ donation, how characteristics of potential recipients affect willingness to consider living liver donation, and whether there are any associations related to a person's willingness to consider non-directed living organ donation.
A cross-sectional survey was distributed in-person on a large medical campus, and participation was incentivized with the opportunity to spin a prize wheel. In addition to participant characteristics, the survey queried awareness of directed and non-directed living donation, whether or not the participant would consider directed donation and non-directed donation, motivating and discouraging factors to living donation, vignettes to assess willingness to donate to recipients with different characteristics, and an altruism personality inventory. An optional interpersonal reactivity index was included as well.
Three hundred twenty-six participants scanned a QR code to take the survey. Most participants (299 of 318, 94%) were aware of living donation. Participants who said yes to considering non-directed living donation (67 of 305, 22%) had significantly higher altruism scores than those who said no (123 of 305, 40%). Willingness to consider living liver donation varied based on recipient characteristics, with participants reporting they would be more willing to donate to a recipient with an immune disorder over alcohol-related liver disease, an infant over an adult, a relative over a nonrelative, and a sibling with alcohol-related liver disease over a nonrelative with alcohol-related liver disease.
The most motivating factors for considering living donation were having a child recipient, helping someone in need, high transplant center success rate, and helping a family member or friend. The most discouraging factors were uncompensated expenses, difficulty of surgery recovery, risk of surgery, and length of recovery. Participants were less willing to donate to adults, strangers, and recipients with alcohol-related liver disease.
在美国，仅18%的肾脏和肝脏移植来自活体供体，提高活体器官捐赠率有助于减少关键器官短缺。非定向活体捐赠更为少见，仅有1.4%的肾脏和肝脏移植来自匿名捐赠者（1）。本研究旨在确定哪些因素对活体器官捐赠更具激励作用和阻碍作用，潜在受者的特征如何影响考虑活体肝脏捐赠的意愿，以及一个人的非定向活体器官捐赠意愿是否存在相关因素。
在一个大型医学园区进行了一项横断面调查，通过有机会转动抽奖轮盘来激励参与。除了参与者特征外，调查询问了定向和非定向活体捐赠的知晓情况、参与者是否会考虑定向捐赠和非定向捐赠、活体捐赠的激励和阻碍因素、用于评估向具有不同特征的受者捐赠意愿的 vignettes，以及一份利他主义人格量表。还纳入了一个可选的人际反应指数。
326名参与者扫描二维码参与了调查。大多数参与者（318人中的299人，94%）知晓活体捐赠。表示愿意考虑非定向活体捐赠的参与者（305人中的67人，22%）的利他主义得分显著高于表示不愿意的参与者（305人中的123人，40%）。考虑活体肝脏捐赠的意愿因受者特征而异，参与者表示他们更愿意向患有免疫疾病的受者而非患有酒精性肝病的受者捐赠，向婴儿而非成年人捐赠，向亲属而非非亲属捐赠，向患有酒精性肝病的兄弟姐妹而非患有酒精性肝病的非亲属捐赠。
考虑活体捐赠的最主要激励因素是有儿童受者、帮助有需要的人、移植中心成功率高，以及帮助家庭成员或朋友。最主要的阻碍因素是无补偿费用、手术恢复困难、手术风险和恢复时间。参与者不太愿意向成年人、陌生人以及患有酒精性肝病的受者捐赠。
