The Impact of Gender, Ethnicity, and the COVID-19 Pandemic on Organ Donation Intentions Over 50 Years in New Zealand.

Aim: To identify the demographics and trends of individuals intending to donate their organs, based on intentions at the time of driver's license registration.

Methods: Data were collected from 4 742 475 individuals first registering for a New Zealand (NZ) driver's license, between January 1, 1974, and November 16, 2023, with positive or negative organ donor intentions recorded. Gender, ethnicity, and year of registration were collected. Predictors of positive organ donation intention were examined with a multivariate logistic regression model.

Results: A positive response to the question regarding organ donation intentions was reported in 2 476 914 individuals (52.2%). This included 1 201 275 males (48.4%) and 1 275 639 females (56.4%). Positive organ donation intention was reported in 1 695 672 NZ Europeans (66.2%), 246 303 Māori (36.2%), 76 749 Pasifika (27.6%), 273 879 Asians (34.4%), 52 137 Middle Eastern, Latin American and African (MELAA) (47.0%), 48 876 "Other" ethnicity (63.5%), and 83 298 "Not otherwise specified" (34.7%). On multivariate logistic regression, the female gender was associated with an increased likelihood of organ donation intention (OR 1.37, p < 0.001), and driver's license registration in a more recent year was associated with an increased likelihood of organ donation intention (OR 1.02, p < 0.001). Compared to all other ethnicities, NZ Europeans were associated with a higher likelihood of positive organ donation intention.

Conclusions: This is the largest study of organ donation intention published in Australasia. It demonstrates a higher likelihood of organ donation intentions in females, ethnic differences, and increasing donation intention rates over time. Further investigation is required to explore the difference between intentions and end-of-life organ donation.