Objective: The growth of the national transplant waiting list continues to far outpace the number of available organs, particularly among African Americans (AA). This study seeks to identify predictors of organ donor registration among AA men, a group with great transplant need, but historically low organ donation rates.

Methods: A cross sectional study based on a 19-question survey assessing knowledge and beliefs surrounding organ donation and transplantation was administered to 562 men, 88.8% of whom were AA, throughout Northeast Ohio at a tertiary care center

Results: A total of 562 men completed the survey (response rate 80.2%). Compared with non-AAs, AAs had significantly lower organ donor registration rates (35.5% vs 60.3%, P<0.001). AA registered donors and non-donors had similar (organ donation literacy), and knowledge did not predict donor status. The odds of being a registered donor increased 81.0% among AAs who knew transplant recipients compared to those who did not (P<0.001). The odds of being a registered donor decreased 70.0% and 53.0% among AAs who believed or were unsure that donors should be paid, respectively, as compared to AAs who did not hold this belief (P=0.004). Though 44.3% of AAs believed or were unsure if doctors would allow them to die in an emergency to harvest their organs and 51.7% of AAs expressed some level of mistrust in doctors, neither belief was predictive of donor status. AAs ranked themselves, spouses, and other relatives as top sources most likely to influence them to become registered donors.

Conclusions: Future donor registration promotion efforts among AAs should focus on exposing AAs to family, friends and community members who are transplant recipients. Compensation for organ donation should be revisited.

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