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Survey about being a living organ donor

Thank you for taking part in this survey about being a living organ donor. A living organ donor is a person who gives (donates) an organ to a person whose organ no longer works. Usually, they donate a kidney or a part of their liver. During living organ donation, doctors do surgery to remove an organ from a living person and put it into the person they are donating to.

About this survey: The National Living Donor Assistance Center (NLDAC) wants to better understand the decision to be a living organ donor. NLDAC will use the findings from this survey to improve programs that help living donors. We want to hear from people at all steps of the decision-making process, including if you have never thought about being a living organ donor or have already decided not to donate an organ. It will take about 10 minutes to complete.

We respect your privacy: We will keep your answers private and anonymous – we will report only group data. You will have a choice to give your contact information at the end of the survey. If you choose to give your contact information such as your phone number or email address, your responses may no longer be anonymous to the research team. However, we will not include your name or identifying information in any publications or presentations based on your data, and your responses to this survey will still be confidential.

If you have any questions about the program, please contact NLDAC at (703) 414-1600 or toll free at (888) 870-5002.

Click below to begin the survey. In doing so, you agree to take part in the survey and to allow us to use your survey responses as described above. If you do not want to take part in the survey, please close your Internet browser.
First, we'll ask some questions about being a living donor and your relationship to the person who needs an organ.
1) Have you ever thought about being a living organ donor?

Yes
No

1b) What organ have you thought about donating?
1b) What organ are you being evaluated to donate?
1b) What organ will you donate?
1b) What organ were you evaluated to donate?
1b) What organ did you already donate?
Please check all that apply.

Kidney
Liver
1c) What is your relationship to the person who needs an organ (the recipient)? If you are doing paired organ donation, what is your relationship to the person who you originally wanted to donate your organ? Paired organ donation means that you are giving your organ to a stranger and the person who you originally wanted to donate to is getting an organ from someone else. In other words, you swap recipients with another donor.
1c) What was your relationship to the person you donated an organ to (the recipient)? If you did paired organ donation, what is your relationship to the person who you originally wanted to donate your organ? Paired organ donation means that you gave your organ to a stranger and the person who you originally wanted to donate to is getting an organ from someone else. In other words, you swapped recipients with another donor.

Please specify relationship

Family member in your household

Family member not in your household

Friend

Acquaintance (someone I know personally, but not well)

Someone I do not know personally who I heard needs an organ (such as someone I heard about through social media or word of mouth)

I did not originally know who would receive my organ or still do not know (non-directed donation)

Please specify family member

Parent
Brother or sister
Child
Spouse
How did you hear of this person and their need for a transplant?

Social media
Through religious group or religious institution
Donation matching website
Billboard or sign
1d) How emotionally close do you feel to the person who needs an organ? Please mark a number on the scale below, where 1 means that you are not close to the person at all and 7 means that you are extremely close to the person.

1 2 3 4 5 6 7

Not close at all Extremely close

	Origin(s)
Origin 1
Origin 2
Origin 3
Origin 4

	Origin(s)
Origin 1
Origin 2
Origin 3
Origin 4

	Origin(s)
Origin 1
Origin 2
Origin 3
Origin 4

	Origin(s)
Origin 1
Origin 2
Origin 3
Origin 4

	Origin(s)
Origin 1
Origin 2
Origin 3
Origin 4

Survey about being a living organ donor

First, we'll ask some questions about being a living donor and your relationship to the person who needs an organ.

Next, we’ll ask about reasons that may make you decide to be a living organ donor. Please tell us how much you agree with each statement.

Next, we’ll ask about reasons that may make you decide NOT to be a living organ donor. Please tell us how much you agree with each statement.

Each statement below is about something that might make you feel more confident about becoming a living organ donor. Please tell us how much you agree with each statement.

Now, we’ll ask you questions about financial issues related to living organ donation.

Last, we’ll ask some background questions about you. This helps us better understand the people who take this survey.