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

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.

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.

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).

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.