This recent article from the BBC discusses how the practice of stranger kidney donations has been increasing in the United Kingdom since it was made legal in 2006. Just to be clear, this refers to kidney donations while the donor is still alive and wherethe donor and recipient don’t know each other. The entire practice seems kind of fascinating to me. Although I carry my donor card around with me and have registered with the National Bone Marrow Registry, I don’t know if I could ever donate an organ to a stranger while I’m still alive.

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I wondered who exactly these donors were, what might instill that kind of altruism, and if gender dynamics might play a role. It turns out, according to this article published in Medicine, Health Care, and Philosophy that gender plays a pretty big role in living organ donation. Apparently, women are much more likely to be living organ donors, making up 58% of kidney donors compared to men’s 42%. At the same time, women are less likely to receive a kidney. These statistics can’t be explained by the thinking that maybe more men need kidneys, so their wives donate more often, because women are also more likely to donate to strangers and non-relatives and more likely to donate to their children and siblings, even when the recipient’s male relative (father or brother) is also a match.
According to a 2008 German study (can be downloaded here), women are also much more likely to be in favor of the idea of donating organs than men are, even if they don't have an organ donor card (in pretty much all cases, whether they are living or dead at the time of donation and whether the recipient is either a distant relatives or stranger). Interestingly, women are also much more likely to be disapproving of proposals of financial compensation for organs than men, who approve such proposals by a large majority.

So what makes women so much more willing to donate their organs? We’ve all heard the psychological behavioral studies that show that, in general, women are more empathetic and altruistic than men, and many of these studies are referenced in the first paper linked above. It does seem to me that society tells women that to be successful as women, they must excel at being caregivers, to their children, significant others, and their community at large. It seems that this conditioning could be a large part of why women donate more often. On the flipside, maybe men are prevented from donating as often as women. This could be because they are traditional breadwinners of the family, and therefore don’t think the risk or leave from work required for the surgery is worthwhile. There is also the fact that men are more likely to fear that having an organ donor card could mean that they get inadequate medical care (doctors might not fight so hard to save his life if his organs are desperately needed.)1

What do you think? Would you donate an organ while alive? Would the identity of the recipient influence your decision at all? Do you think your identity as a woman affects your feelings on the issue?

  • 1. Thompson T.L.; Robinson J.D.; Kenny R.W. “Gender Differences in Family Communication About Organ                   Donation.” Sex Roles, Volume 49, Numbers 11-12, 200312 , pp. 587-596(10)

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Comments

Hi Candace - I manage campaign outreach for Donate Life Illinois. Very nice post and thanks for sharing the stats. It is quite interesting and we've also found that women generally tend to register moreso than men as organ donors and overall be more engaged in the issue.

I thought you might enjoy this video we did about Amanda, the youngest recorded non-direct living donor, very inspirational story. http://www.youtube.com/watch?v=2Mj3OxBYDwA

-Scott
www.DonateLifeIllinois.org

I'm totally going to donate my organs when I pass ... I've never thought about being a living donor though (with the exception of bone marrow - I did join the national bone marrow registry). While it would be harder to give something like a kidney to a stranger, I'd like to think that I would - it's definitely something to think about! Thanks for the post, Candace!

Scott, thanks so much for that video! I love how she brings up the point about breaking expectations. I've been part of the bone marrow donor registry for over 5 years now, and I was surprised at how psyched I was to get the call saying that I might be needed to donate. They ended up finding someone closer, but I can still see how that altruism could give you a major boost.

The video also shocked me with the stat that only 50% of people sign up to be organ donors when they die. I'm adamant that every single part of me be used when I die, if at all possible. Excluding religious reasons, I can't fathom why people would feel better about letting their organs rot rather than allowing them to save lives.

This article was very interesting and I learned a lot from reading it. Also, thanks for the video. It was very inspirational, I was surprised about how few people choose to donate their organs. This video made me reconsider my thoughts about organ donation. Thanks!

My pleasure, we have all our videos housed at www.youtube.com/DonateLifeIllinois.

Michelle, funny you mention. Amanda had gone in for a routine check-up after her surgery (yes, the donation was done anonymously) and was chatting up the person sitting next to her in the waiting room. It didn't take but a few minutes before they realized this person was Amanda's recipient. Crazy.

Candace, I know, 50% seems utterly ridiculous. Check out the two links on the left sidebar here for 2009 national survey results and the Donate Life America report card - http://donatelife.net/.

I just read a Newswise article this morning that talks about a recent article in the Journal of the American Society of Nephrology. The researchers analyzed data from the United States Renal Data System from 1990 to 2004 and determined that women who receive a kidney from a deceased male donor are 12% more likely to have transplant failure in the 1st year. No increased risk was found by the 10 year mark. The study indicates that women may have an immune response to H-Y antigens from the Y chromosome. You can read the newswise article here http://www.newswise.com/articles/view/554736/?sc=dwhp or the JASN article at http://jasn.asnjournals.org/

Thanks, Michelle! When I was preparing the article, I kept coming across data showing that kidneys from female donors had a higher chance of being rejected. It seems like that could simply be because most of the recipients of these "female" kidneys are males. A study very similar to yours that was published in the lancet (read here: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(08)60992-7/fulltext) ends with the suggestion that both sexes would benefit from sex-matched organs (or kidneys, at least).

If the medical profession actually followed that mandate in order to have the highest chance of success, it would be very interesting to see how the donor/recipient ratio played out. Would more men step up to donate if there was a clear "male kidney" deficit? Either way, I kinda love this topic because of the way it beautifully exemplifies the need for health research on both genders, even on a topic that seems like it would be gender neutral.

This article made me feel a little better about American organ donation. http://www.cnn.com/2009/WORLD/asiapcf/08/26/china.organ.donation/index.h...
According to it, only 36 people donated their organs last year in China. 36???? In the world's most populated country? Apparently, most of the "donated" organs come from executed prisoners. There are obviously some huge cultural differences going on in the way I feel about that policy, but the entire article article shocked me. Only 36 people out of 1.3 billion! Crazy!

I had a friend that died this year because of kidney complications. He was waiting to get on the list and hopeful things would work out. I had just talked to him a week before he passed, I was very shocked when I found out the news. He went through a lot at such a young age.

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