What Would Motivate You To Donate a Kidney (While You’re Alive)?

As of February 2025, 99,352 people were on the waiting list for a kidney or liver transplant (the two most common transplanted organs, with kidneys making up the vast majority) in the United States. In 2024, 39,217 received a new organ, and 10,057 were removed from the list because they died waiting or became too sick to receive a transplanted kidney or liver.

Clearly, there is a critical shortage of organs available for transplantation.

One untapped source is living donors. Just 18% of donor kidneys and livers in 2025 came from people who were alive, and just 1.4% (455 kidneys) were non-directed donations, meaning that they were anonymous, with the recipient unknown to the donor, rather than the more common directed donations to a family member or friend.

Cultural factors are a surprisingly big player here. Western societies have tended to focus on promoting deceased donation. Eastern/Asian societies, where there are strong cultural and religious beliefs that the body should be kept intact for the burial and afterlife, have the opposite focus. More than 90% of liver transplants in the East are from living donors.

A study published in Frontiers in Public Health on March 26, 2025,examined survey respondents’ attitudes about living donation and the reasons they would be more or less likely to donate and how they differed between directed donation and non-directed donation.

Rachel A. Davis, M.D.

Corresponding author Rachel A. Davis, M.D., an associate professor in the Department of Psychiatry with a secondary appointment in the Department of Neurosurgery at the University of Colorado’s Anschutz Medical Campus in Aurora, Colorado, where she also is vice chair of clinical affairs and strategy and chief of CU Medicine Psychiatry Community Practices and colleagues, all on the Anschutz campus, were most interested in people’s motivations.

For one week in July 2024, they set up tables in an administrative building and near food trucks (sometimes recruiting people who walked by) on the medical campus, which serves about 4,500 health professional and graduate students and employs 10,000 faculty and staff, and hosts many outpatient clinics and a large hospital. A total of 318 people aged 18 and older were included in the study.

Survey participants were quite different from the average American: 72% were female, 19% had doctoral degrees, the average age was 30, and just 4% were Black (14% identified as Hispanic or Latino, and another 14% as Asian/Pacific Islander; 55% were white). The survey did not ask their role on campus, but the researchers wrote that people likely to be near where the tables were located include health professional students, clinicians, researchers, staff, and patients — in other words, a group that is likely far more familiar with medical procedures than most and perhaps more altruistic as well.

That familiarity may be part of the reason that a large majority (73%) of participants said they were aware of both living kidney and living liver donation; one had donated a kidney. More than half (53%) said they would be willing to donate a kidney and/or part of their liver to someone they knew, and another 35% said maybe they would. Just 11% said they would not.

Nondirected living donation had less support: 22% said they would consider it, while 38% said maybe and 40% said no. An optional part of the survey was designed to measure altruism, and participants higher in altruism were more likely to say they’d consider nondirected donation.

Motivating factors

The most motivating factors for considering living donation included having a child recipient, helping a friend or family member, helping someone in need and potentially saving a life, and a high transplant center success rate. Those who answered yes to considering nondirected donation had statistically significant higher levels of motivation than participants who answered no for helping someone in need and potentially saving a life, a high transplant center success rate, and having a child recipient.

Among the most discouraging factors for considering living donation was uncompensated expenses (an unrelated study found that 89% of living donors had incurred a net financial loss, including direct and indirect costs, ground transportation, health care, medications, and lost wages, and a third said it cost them more than $2,500). Other discouraging factors were the difficulty of recovery from surgery, risk of surgery, and length of time for recovery.

Participants offered a number of reasons why they would consider nondirected donation, such as “Would love to donate to help people and save people!” and “I would choose to donate because I think about my family [cq] who is in need and I would want the same.”

Among the concerns: “[I] would not be able to see the impact” and “It would be a hard process to do for someone I do not know.”

Davis and her co-authors acknowledged that their findings were limited by a sample that was small and made up entirely of people on a medical campus. They said the next step would be to distribute surveys to other populations and also suggested exploring additional motivating and discouraging factors such as religious beliefs, personal health status, or exposure to social media.