Exploring Public Perspectives on Organ Donation in Makkah, Saudi Arabia

Background Organ donation involves giving organs to help others in need of transplants. It can be carried out while the individual is still alive or after death (e.g., kidney donation). Strict legal requirements and moral principles govern this life-saving action. Because supply is limited and demand is strong, awareness and registration are essential. In Saudi Arabia, despite religious rulings (fatwa) permitting organ donation since 1982, significant gaps persist between transplant demand and donor availability. Objectives This cross-sectional study aimed to evaluate knowledge, attitudes, and barriers regarding organ donation among adults in Makkah. Methods A cross-sectional study was conducted online using Google Forms (Google, Inc., Mountain View, CA) from 04 December to 30 December 2024 to investigate public perspectives on organ donation in Makkah, Saudi Arabia. A convenience sampling strategy was employed, and the questionnaire was distributed via various social media channels, including among adult residents of Makkah aged 18 years or older. Age eligibility was verified by self-report, with responses from individuals under 18 excluded. Associations between categorical variables were assessed using chi-squared tests, with effect sizes reported using Cramer's V. Results The study surveyed 1,184 residents of Makkah to assess public perspectives on organ donation. Most respondents were young (58.1%, n = 688 aged 18-25), female (65.2%, n = 772), and Saudi (94.7%, n = 1,121), with nearly half holding university degrees (47.1%, n = 558). Despite the high willingness to donate to family or friends (72.7%, n = 861), only 8.2% (n = 97) had an organ donor card, and 6.4% (n = 76) had formally signed one. The internet was the primary source of information (45.4%, n = 538), while knowledge about donation eligibility was variable: most correctly identified kidney (63.7%, n = 754) and liver (53.4%, n = 632) as living-donor organs, but some incorrectly believed the heart (4.9%, n = 58) or brain (3.9%, n = 46) could be donated by living donors. Religious beliefs influenced 43.3% (n = 513) of participants, and 29.4% (n = 348) reported beliefs that hinder donation. Most prioritized donating to the sickest patients (87.7%, n = 1,038) and younger recipients. Willingness to donate (defined as possessing or signing a donor card) was significantly associated with knowing a living organ donor (chi-squared test, p < 0.001, Cramer's V = 0.153), absence of religious barriers (p = 0.002, V = 0.099), and perceived personal importance of donation (p < 0.001, V = 0.136). Nearly all participants (91.7%, n = 1,086) agreed that the public needs more information about organ donation. Conclusion This study reveals a significant gap between expressed willingness to donate (72.7%) and actual donor registration (8.2%). The strongest predictors of positive donation attitudes were personal connections to organ donation (14.3% vs. 5.8% willing among those with vs. without knowing a living donor, p < 0.001) and perceived personal importance. Public health interventions should focus on converting positive attitudes into action through simplified registration processes and continued engagement with religious scholars to address misconceptions.