Public knowledge and perceptions of kidney transplantation in Singapore: findings from a pilot survey

INTRODUCTION: Despite kidney transplantation being the gold-standard treatment for end-stage renal disease, organ donation rates remain low. This study examined public perceptions and barriers to kidney donation to guide future efforts in Singapore. METHODS: An online survey on kidney donation knowledge and attitudes was distributed via FormSG. Categorical data were presented as counts and percentages, and chi-square tests were used for categorical comparisons. RESULTS: Of the 633 respondents, 91% were Singaporeans, 55.8% were female, 20.7% had medical background, 81.6% had university education and 59.5% had a household income >SGD 8000. While 94.3% were familiar with the term 'kidney transplantation', only 70% knew about Human Organ Transplant Act (HOTA), with higher awareness among older adults (P < 0.01), those with a medical background (P < 0.01) and higher-income groups (P = 0.01). Only 25.1% correctly identified organs covered by HOTA and 82.8% incorrectly believed the next of kin could refuse donation after brain death. Overall, 66.7% of respondents were willing to donate, with greater willingness among postgraduates (P = 0.02) and Hindus (P < 0.01); the strongest motivator was the relationship to the recipient (80.5%), while key deterrents were health concerns (49.6%) and financial impact (25.9%). Most (75.2%) incorrectly thought donor surgery was open rather than laparoscopic. Willing donors perceived higher transplant success rates (73.2% vs. 65.7%, P < 0.01) but underestimated actual success (85%-99%, P < 0.01). CONCLUSION: Our study identified several knowledge gaps about kidney transplantation, including HOTA provisions, donor nephrectomy approach, recovery period and long-term donor health outcomes. Sociocultural and economic factors influence the willingness to donate, necessitating targeted interventions to improve awareness and address misconceptions.