What determines people’s willingness to donate a kidney as part of an organ exchange programme?

Living organ donation through exchange programmes, where donors are anonymously matched with recipients, is a growing practice that addresses compatibility barriers in transplantation. However, limited research explores predictors influencing individuals' willingness to engage in such programmes. This study used the prototype willingness model (PWM) along with moral norm to examine key predictors of people's willingness to participate in living organ (kidney) donation within an exchange programme based on a hypothetical scenario. Given the recent introduction of a national exchange programme, participants (<i>N</i> = 147) were adult Australians with no current conditions affecting organ donation eligibility. Hierarchical multiple regression analysis showed attitudes towards organ donation and similarity to a typical organ donor significantly contributed to people's willingness to donate their kidney via an exchange programme. Moral norm, the personal belief that organ donation is a moral obligation, also predicted willingness. Willingness to donate in an exchange programme is more closely tied to one's personal attitude, self-image (similarity to a typical donor) and moral obligation than any external social pressures. Given their increasing prevalence, future research should continue to explore individuals' motivations for donating in exchange programes which are crucial for enhancing donor recruitment efforts to save lives.