Factors Influencing Living Kidney Donation in Singapore

Abstract

Context— Kidney transplantation is the best treatment option for kidney failure, but the supply of donor kidneys remains small. Objective— To understand the public's attitude toward living donor kidney donation in Singapore. Design, Setting and Participants, Intervention, Outcome Measures— A cross-sectional study of a convenience sample of 1520 members of the general public seeking care at local medical centers. A self-administered questionnaire included questions on demographics and subjects' willingness and unwillingness to donate a kidney. Respondents were aged at least 18 years and did not have underlying chronic kidney disease, end-stage renal disease requiring dialysis, or history of kidney transplant. Results— Overall mean age of respondents was 49 (SD, 15) years and 50% were male. Response rate to the question on “willingness to donate kidney while alive” was 96% (1460); 707 (48.4%) were willing to donate a kidney while alive. Respondents who were willing to donate were younger (<40 years; P < .001); had above a secondary level education ( P < .001); had monthly household income 2000 SGD (or US$1660; exchange rate at 1 SGD = US$0.83) or higher ( P< .001); were not married, single, or divorced ( P< .001); and were professionals ( P< .001). Fear of surgical risks (86.5% strongly agree or agree) and poorer health consequent to donation (87.5% strongly agree or agree) were the main reasons for not considering being a living kidney donor. Demographic factors and concerns of surgical risks and ill health after transplant influenced willingness to donate a kidney while alive. Addressing these concerns may alleviate anxiety with regard to living kidney donation.