Attitudes to organ donation in Lebanon: A cross-sectional survey

Background

The optimum approach for managing terminal illnesses is organ transplantation. However, the transplant waiting list is long due to the very high demand and low supply of donated organs. One's willingness to donate is governed by their knowledge and attitude towards organ donation. The perception of organ donation among the Lebanese general population and their desire to donate organs has not been previously explored. This study aims to assess the attitudes of Lebanese to organ donation and evaluate the public's relative knowledge about this particular notion and their willingness to donate organs.

Methodology

This study is a cross-sectional design including a self-administered questionnaire that was distributed through an online link during June and July, 2022. The study population consisted of Lebanese respondents of ages eighteen years old and above from the different governorates of Lebanon. The respondents’ knowledge, attitudes and willingness to organ donation were collected by a cross-culturally adapted questionnaire from Chinese-based previous research. Knowledge is measured by 10 items and presented as a 10-point score, attitude is scored by 20 items on a 5-step Likert scale, and the total score ranges from 0 to 80; while the willingness to donate is assessed as a trinomial variable (Yes, No, Maybe). Statistical analysis was carried out using the statistical software SPSS version 26.0. Multivariate regression was applied to adjust factors associated with organ donation attitudes, controlling for demographic and socioeconomic confounders. All tests were reported two-tailed, with a significance level of P-value < 0.05.

Results

A total of 500 respondents completed the questionnaire, where most have heard about organ donation (100%) and brain death (92.6%). The overall median (± IQR) score of attitudes to organ donation was 48 ( ± 11), and was higher among participants who were willing to donate organs. The total attitude score was found statistically significant across different age groups (P < 0.05), gender (P < 0.01), residency districts (P < 0.05), and average monthly income (P < 0.05). The willingness to organ donation was predominantly indifferent (47.4%) with only 21.6% willing to donate organs. However, if religion and law were encouraging organ donation, the majority were willing to donate organs (59.6%). The correlation between total attitude score and the variables is positive (R = 0.295) and 8.7% of the variation seen in the total attitude score is explained by the variables (R² = 0.087). After adjustment, the adjusted P-values for the total attitude score on willingness, knowledge, and gender remained significant (P ≤ 0.001).

Conclusions

The general public's attitudes to organ donation in Lebanon was found to be supportive and highly associated with the knowledge of the topic. The willingness to donate organs is correlated to the supportive attitudes and may increase as more people get familiar with the notions of brain death and the transplant process.