Investigating Organ Donation Registration Among Older Adults in Sweden, a Survey Study

Organ donation and transplantation can be lifesaving. Many donors are older adults. National Donor Registries can promote adherence to patients' rights and safeguard patient integrity if the question about organ donation arises. However, a majority have not entered the National Donor Registry in Sweden.

Investigate how sociodemographic factors, health-related factors, and attitudes toward organ donation are associated with whether or not older adults in Sweden are registered in the National Donor Registry.

A cross-sectional survey design was chosen to explore associations between individual characteristics and registration behavior among older adults. Data was collected through the Swedish National Study on Ageing and Care (SNAC)-IT survey in 2023, a sub-study to the SNAC. 436 participants 60 years old or older answered the survey. The survey included questions on sociodemographic and health-related factors and attitudes toward organ donation. Data was analyzed using descriptive statistics, Spearman's rank correlation, and the Chi-square test.

Registration in the Swedish National Donor Registry was low among older adults, with only 25.5% of participants listed despite 70.4% expressing a positive attitude toward organ donation. Among those who oppose organ donation only 6.9% were in the registry. Younger age, higher self-rated health, better health-related quality of life (EQ-5D VAS), being unmarried, being a previous smoker, and having a positive attitude toward donation were all significantly associated with being registered (p < 0.05). These findings demonstrate a gap between supportive beliefs and registration behavior among older adults.

There is a gap between beliefs and actions regarding organ donation among older adults. While most have a positive attitude toward organ donation, they are not registered in the National Donor Registry. Additionally, the vast majority who oppose organ donation after death are not registered, raising the risk that their actual wishes may be disregarded due to presumed consent.