S D Med. 2026 May;79(suppl 5):s34-s35.
ABSTRACT
INTRODUCTION: More than 100,000 patients are on the U.S. transplant waitlist, with proportionally fewer organ donations coming from rural areas. Optimization of donation services in rural and frontier communities could address this discrepancy. We sought to better understand attitudes, knowledge, and concerns regarding organ donation and transplantation among frontier populations by surveying patients in the United States Great Plains region.
METHODS: A 15-item survey was distributed for voluntary completion to patients ≥18 years at three rural clinics in the Great Plains from July 2025 to January 2026. The survey included questions on demographics, exposure to and knowledge of organ donation, and attitudes regarding organ donation and transplantation. A total knowledge score was created by scoring participants’ accuracy in selecting which organs/tissues can be donated. Statistical analyses included Fisher exact and Mann Whitney U testing, as well as a multiple logistic regression. A p-value of ≤0.05 was considered significant.
RESULTS: Among 101 respondents (74.3% female, 77.2% registered donors), 90.1% were White and 7.9% were Native American/Alaska Native (NA/AN). Registered donors had significantly higher knowledge scores than non-donors (p=0.0012). Men were more likely to limit transplant acceptance to donations from friends/relatives (p=0.024), while NA/AN respondents showed higher willingness for unconditional living donation (p=0.039). Multivariable regression identified knowledge score as the sole independent predictor of donor status amongst variables surveyed (OR 1.48; 95% CI 1.13-1.99). The primary concern with donation reported was fear of health complications (37.5%) and the most requested intervention was more information on the donation process (18.1%).
CONCLUSION: Medical literacy appears to be positively associated with organ donor status in this population. Sex-, race-, and education-specific differences in donation attitudes exist and may inform targeted interventions. Addressing knowledge gaps and specific concerns through education and outreach could provide a strategy to increase donation rates in rural populations.
PMID:42526002
