Living Kidney Donation in the Public Eye: Motivations, Misconceptions, and Missed Opportunities

Background: There is limited data on public attitudes toward living kidney donation in San Antonio. Understanding community perspectives is essential to improving education and donor engagement. Methods: A community survey was conducted to assess awareness of chronic kidney disease (CKD), its causes, treatment options, and views on living kidney donation. Surveys were distributed in parks and via email across San Antonio. Results: Among 346 respondents (112 men, 228 women; 52.6% Hispanic), 17.1% knew someone on dialysis and 22.8% knew a kidney transplant recipient. While 58% were registered donors on their driver's license, only 21.8% knew a living donor. Only 68 individuals (19.6%) expressed interest in living organ donation. Of those, 66% cited helping someone in need as the main reason, while 41% mentioned reassurance of good health post-donation. Financial compensation (13%) and lifetime insurance (12%) were less commonly cited. Among 275 not interested in donating, 43% feared long-term complications, 31% feared surgery, 19% were concerned about wage loss, and 10% cited religious reasons. Misconceptions were common. About 9.9% believed only family members could donate, 12.3% thought insurance was needed to donate, 12.6% believed donors were financially rewarded, 22.3% thought donation increased kidney disease risk, and 12.8% believed it shortened lifespan. When asked about potential recipients, 50.8% were willing to donate to a family member, 28.3% to any person in need, 21% to someone with a compelling story, 16.8% to a child, and 11.3% to a parent of a young child. Conclusion: Although many residents support kidney donation in theory, willingness to become a living donor is low. Fear, misinformation, and logistical concerns are key barriers. Targeted education that addresses safety, eligibility, and outcomes and corrects misconceptions may improve donor participation.