{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T11:00:46Z","timestamp":1759230046617,"version":"3.41.2"},"reference-count":58,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,1,4]],"date-time":"2023-01-04T00:00:00Z","timestamp":1672790400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Living kidney organ donors offer a cost-effective alternative to deceased organ donation. They enable patients with life-threatening conditions to receive grafts that would otherwise not be available, thereby creating space for other patients waiting for organs and contributing to reducing overall waiting times for organs. There is an emerging consensus that an increase in living donation could contribute even more than deceased donation to reducing inequalities in organ donation between different population sub-groups in England. Increasing living donation is thus a priority for National Health Service Blood and Transplant (NHSBT) in the United Kingdom.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Using the random forest model, a machine learning (ML) approach, this study analyzed eight waves of repeated cross-sectional survey data collected from 2017 to 2021 (<jats:italic>n<\/jats:italic> = 14,278) as part of the organ donation attitudinal tracker survey commissioned by NHSBT in England to identify and help predict key factors that inform public intentions to become living donors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, around 58.8% of the population would consider donating their kidney to a family member (50.5%), a friend (28%) or an unknown person (13.2%). The ML algorithm identified important factors that influence intentions to become a living kidney donor. They include, in reducing order of importance, support for organ donation, awareness of organ donation publicity campaigns, gender, age, occupation, religion, number of children in the household, and ethnic origin. Support for organ donation, awareness of public campaigns, and being younger were all positively associated with predicted propensity for living donation. The variable importance scores show that ethnic origin and religion were less important than the other variables in predicting living donor intention.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Factors influencing intentions to become a living donor are complex and highly individual in nature. Machine learning methods that allow for complex interactions between characteristics can be helpful in explaining these decisions. This work has identified important factors and subgroups that have higher propensity for living donation. Interventions should target both potential live donors and recipients. Research is needed to explore the extent to which these preferences are malleable to better understand what works and in which contexts to increase live organ donation.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2022.1052338","type":"journal-article","created":{"date-parts":[[2023,1,4]],"date-time":"2023-01-04T16:55:27Z","timestamp":1672851327000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["A machine-learning approach to estimating public intentions to become a living kidney donor in England: Evidence from repeated cross-sectional survey data"],"prefix":"10.3389","volume":"10","author":[{"given":"Paul","family":"Boadu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leah","family":"McLaughlin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mustafa","family":"Al-Haboubi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer","family":"Bostock","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jane","family":"Noyes","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen","family":"O'Neill","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicholas","family":"Mays","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2023,1,4]]},"reference":[{"key":"B1","unstructured":"UK's living kidney sharing scheme to hit 1000th transplants milestone this week"},{"key":"B2","unstructured":"UK Living Kidney Sharing Scheme"},{"key":"B3","unstructured":"Organ Donation Registry Fact Sheet"},{"key":"B4","unstructured":"UK Living Kidney Sharing Scheme"},{"key":"B5","doi-asserted-by":"publisher","first-page":"530","DOI":"10.1038\/nbt.3889","article-title":"The promise of organ and tissue preservation to transform medicine","volume":"35","author":"Giwa","year":"2017","journal-title":"Nat Biotechnol"},{"key":"B6","unstructured":"2022"},{"key":"B7","unstructured":"2022"},{"key":"B8","unstructured":"2022"},{"key":"B9","unstructured":""},{"key":"B10","unstructured":"Global Observatory on Donation and Transplantation2022"},{"key":"B11","doi-asserted-by":"publisher","first-page":"457","DOI":"10.1162\/0033553041382157","article-title":"Kidney exchange","volume":"119","author":"Roth","year":"2004","journal-title":"Quart J Econ"},{"key":"B12","unstructured":"EU Working Group on Living Organ Donation, \u201cAction Plan on organ donation transplantation (2009-2015): Strengthened Cooperation between Member States"},{"key":"B13","doi-asserted-by":"publisher","first-page":"34329","DOI":"10.1097\/01.tp.0000255583.34329.dd","article-title":"Living donor kidney transplantation: the effects of donor age and gender on short- and long-term outcomes","volume":"3","author":"\u00d8ien","year":"2007","journal-title":"Transplantation."},{"key":"B14","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1177\/08968608211061126","article-title":"Current costs of dialysis modalities: a comprehensive analysis within the United Kingdom","volume":"3","author":"Roberts","year":"2022","journal-title":"Perit Dial Int"},{"key":"B15","doi-asserted-by":"publisher","first-page":"71","DOI":"10.14503\/THIJ-18-6747","article-title":"The benefits of a local kidney exchange","volume":"46","author":"Ismail","year":"2019","journal-title":"Tex Heart Inst J"},{"key":"B16","doi-asserted-by":"publisher","first-page":"e047263","DOI":"10.1136\/bmjopen-2020-047263","article-title":"Changes in quality of life (QoL) and other patient-reported outcomemeasures (PROMs) in living-donor and deceased-donor kidney transplant recipients and those awaiting transplantation in the UK ATTOM programme: a longitudinal cohort questionnaire survey with additional qualitative interviews","volume":"11","author":"Gibbons","year":"2021","journal-title":"BMJ Open."},{"key":"B17","doi-asserted-by":"publisher","first-page":"499","DOI":"10.1002\/lt.23575","article-title":"Pomfret, E. A incidence of death and potentially life-threatening near miss events in living donor hepatic lobectomy: a world-wide survey","volume":"19","author":"Yee","year":"2013","journal-title":"Liver Transplant."},{"key":"B18","doi-asserted-by":"publisher","first-page":"1941","DOI":"10.1016\/j.juro.2010.01.021","article-title":"Experience with 750 consecutive laparoscopic donors' nephrectomies\u2013is it time to use a standardized classification of complications?","volume":"83","author":"Harper","year":"","journal-title":"J Urol."},{"key":"B19","doi-asserted-by":"publisher","first-page":"959","DOI":"10.1001\/jama.2010.237","article-title":"Perioperative mortality and long-term survival following live kidney donation","volume":"303","author":"Segev","year":"2010","journal-title":"JAMA."},{"key":"B20","doi-asserted-by":"publisher","first-page":"1273","DOI":"10.1097\/TP.0b013e3181bb44fd","article-title":"Morbidity and mortality in 1,022 consecutive living donor nephrectomies Benefits of kidney transplant living donor registries","volume":"88","author":"Mj\u00f8en","year":"2009","journal-title":"Transplantation."},{"key":"B21","doi-asserted-by":"publisher","first-page":"141","DOI":"10.1111\/bjhp.12344","article-title":"\u2018What if I'm not dead'-myth-busting and organ donation","volume":"24","author":"Miller","year":"2019","journal-title":"Br J Health Psychol."},{"key":"B22","unstructured":"Living Organ Donation2021"},{"key":"B23","doi-asserted-by":"publisher","first-page":"428","DOI":"10.3399\/bjgp19X705173","article-title":"Living donor kidney transplantation: often a missed opportunity","volume":"69","author":"Sharma","year":"2019","journal-title":"Br J Gen Pract."},{"key":"B24","doi-asserted-by":"publisher","first-page":"662","DOI":"10.1016\/S0140-6736(19)32977-0","article-title":"The global burden of chronic kidney disease","volume":"395","author":"Cockwell","year":"2020","journal-title":"Lancet."},{"key":"B25","doi-asserted-by":"publisher","first-page":"e002596","DOI":"10.1136\/bmjgh-2020-002596","article-title":"The impact of country reimbursement programmes on living kidney donations BMJ Global Health","volume":"5","author":"Siddique","year":"2020"},{"key":"B26","doi-asserted-by":"publisher","first-page":"401","DOI":"10.2147\/JMDH.S285011","article-title":"Opt-out consent at different levels of attitude to organ donation: a household survey in Qatar","volume":"14","author":"Singh","year":"2021","journal-title":"J Multidiscipl Healthcare"},{"key":"B27","doi-asserted-by":"publisher","first-page":"1514","DOI":"10.1097\/TP.0000000000002432","article-title":"Building kidney exchange programmes in europe-an overview of exchange practice and activities","volume":"103","author":"Bir\u00f3","year":"2019","journal-title":"Transplantation."},{"key":"B28","unstructured":"Normothermic Kidney Preservation Phase 1 (NKP1)2021"},{"key":"B29","doi-asserted-by":"publisher","first-page":"167","DOI":"10.1186\/s12910-021-00734-z","article-title":"A scoping review of the perceptions of death in the context of organ donation and transplantation","volume":"22","author":"Skowronski","year":"2021","journal-title":"BMC Med Ethics."},{"key":"B30","doi-asserted-by":"publisher","first-page":"204","DOI":"10.1177\/1751143718807842","article-title":"How the mode of organ donation affects family behaviour at the time of organ donation?","volume":"20","author":"Prescott","year":"2019","journal-title":"J Inten Care Soc"},{"key":"B31","doi-asserted-by":"publisher","first-page":"101","DOI":"10.1177\/1751143717738194","article-title":"The Rule of Threes: three factors that triple the likelihood of families overriding first person consent for organ donation in the UK","volume":"19","author":"Morgan","year":"2018","journal-title":"Journal of the Intensive Care Society."},{"key":"B32","doi-asserted-by":"publisher","first-page":"845","DOI":"10.1111\/jan.14601","article-title":"Seeking consent for organ donation: process evaluation of implementing a new specialist Requester nursing role","volume":"77","author":"Laughlin","year":"2020","journal-title":"JAN."},{"key":"B33","doi-asserted-by":"publisher","first-page":"e025159","DOI":"10.1136\/bmjopen-2018-025159","article-title":"Short-term impact of introducing a soft opt-out organ donation system in Wales: before and after study","volume":"9","author":"Noyes","year":"2019","journal-title":"BMJ Open."},{"key":"B34","doi-asserted-by":"publisher","first-page":"485","DOI":"10.1111\/hex.12872","article-title":"Media content analysis of the introduction of a \u201csoft upt-out\u201d system of organ donation in Wales 2015\u201317","volume":"22","author":"Dallimore","year":"2018","journal-title":"Health Expectations"},{"key":"B35","doi-asserted-by":"publisher","first-page":"367","DOI":"10.1080\/13557858.2012.752073","article-title":"Attitudes to deceased organ donation and registration as a donor among minority ethnic groups in North America and the UK: a synthesis of quantitative and qualitative research","volume":"18","author":"Morgan","year":"2013","journal-title":"Ethn Health"},{"key":"B36","unstructured":"Organ Donation and Transplantation: Activity Report 2017\/18"},{"key":"B37","doi-asserted-by":"publisher","first-page":"152","DOI":"10.7182\/pit2014946","article-title":"Hispanic\/Latino concerns about living kidney donation: a focus group study","volume":"24","author":"Gordon","year":"2014","journal-title":"Progress Transplant"},{"key":"B38","doi-asserted-by":"crossref","first-page":"2912","DOI":"10.1111\/ajt.12411","article-title":"Living kidney donor assessment: challenges, uncertainties and controversies among transplant nephrologists and surgeons","volume":"13","author":"Tong","year":"2013","journal-title":"Am J Transplant."},{"key":"B39","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1080\/10810730701807142","article-title":"Intentions of becoming a living organ donor among hispanics: a theory-based approach exploring differences between living and nonliving organ donation","volume":"13","author":"Siegel","year":"2008","journal-title":"J Health Commun"},{"key":"B40","unstructured":"2022"},{"key":"B41","unstructured":"Vienna, AustriaR Foundation for Statistical ComputingR: A Language Environment for Statistical Computing2019"},{"key":"B42","doi-asserted-by":"crossref","DOI":"10.1007\/978-3-319-69014-8","volume-title":"Machine-Learning Techniques in Economics: New Tools for Predicting Economic Growth","author":"Basuchoudhary","year":"2017"},{"key":"B43","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1177\/1536867X20909688","article-title":"The random forest algorithm for statistical learning","volume":"1","author":"Schonlau","year":"2020","journal-title":"The Stata Journal, 20, Number"},{"key":"B44","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1177\/0272989X221100717","article-title":"A Machine-learning approach for estimating subgroup- and individual-level treatment effects: an illustration using the 65 trial","volume":"3","author":"Sadique","year":"2022","journal-title":"Med Dec Making"},{"key":"B45","doi-asserted-by":"publisher","first-page":"1701.01428","DOI":"10.48550\/arXiv.1701.01428","article-title":"Predicting economic recessions using machine learning algorithms","author":"Nyman","year":"2017","journal-title":"arXiv [Preprint]."},{"key":"B46","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1177\/1178630217699399","article-title":"Using machine learning to estimate atmospheric Ambrosia pollen concentrations in Tulsa, OK","volume":"11","author":"Liu","year":"2017","journal-title":"Environmental Health Insights"},{"key":"B47","doi-asserted-by":"publisher","first-page":"2473","DOI":"10.1016\/j.eswa.2007.12.020","article-title":"The comparisons of data mining techniques for the predictive accuracy of probability of default of credit card clients","volume":"36","author":"Lien","year":"2009","journal-title":"Expert Syst Appl."},{"key":"B48","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1023\/A:1010933404324","article-title":"Random forests","volume":"45","author":"Breiman","year":"2001","journal-title":"Mach Learn."},{"key":"B49","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1145\/584091.584093","article-title":"A mathematical theory of communication","volume":"5","author":"Shannon","year":"2001","journal-title":"ACM SIGMOBILE Mobile Comp Commun Rev."},{"key":"B50","doi-asserted-by":"publisher","first-page":"676","DOI":"10.1016\/S0272-6386(98)70037-X","article-title":"When a stranger offers a kidney: ethical issues in living organ donation","volume":"32","author":"Levine","year":"1998","journal-title":"Am J Kidney Dis."},{"key":"B51","doi-asserted-by":"publisher","first-page":"1518","DOI":"10.2215\/CJN.01470217","article-title":"A scoping review for strategies to increase living kidney donation","volume":"12","author":"Barnieh","year":"2017","journal-title":"Clin J Am Soc Nephrol."},{"key":"B52","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1016\/S0140-6736(08)60967-8","article-title":"Organ trafficking and transplant tourism and commercialism: The Declaration of Istanbul","volume":"372","year":"2022"},{"key":"B53","doi-asserted-by":"publisher","first-page":"955","DOI":"10.2471\/BLT.06.039370","article-title":"The state of the international organ trade: a provisional picture based on integration of available information","volume":"85","author":"Shimazono","year":"2007","journal-title":"Bull World Health Org."},{"key":"B54","doi-asserted-by":"publisher","first-page":"131","DOI":"10.1186\/s12916-014-0131-4","article-title":"An international comparison of deceased and living organ donation\/transplant rates in opt-in and opt-out systems: a panel study","volume":"12","author":"Shepherd","year":"2014","journal-title":"BMC Med."},{"key":"B55","unstructured":"Organ Donation and Transplantation Activity Data: United Kingdom2019"},{"key":"B56","doi-asserted-by":"publisher","first-page":"554","DOI":"10.1038\/s41581-021-00425-3","article-title":"Organ donation and transplantation: a multi-stakeholder call to action","volume":"17","author":"Vanholder","year":"2021","journal-title":"Nat Rev Nephrol."},{"key":"B57","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1093\/bmb\/ldac008","article-title":"Tackling organ donation among minority ethnic communities in the UK-a whole systems approach","volume":"142","author":"Randhawa","year":"2022","journal-title":"Br Med Bull."},{"key":"B58","doi-asserted-by":"publisher","first-page":"105","DOI":"10.1017\/S0963180104131174","article-title":"Donor benefit is the key to justified living organ donation","volume":"13","author":"Spital","year":"2004","journal-title":"Cambridge Quart Healthcare Ethics."}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2022.1052338\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,1,4]],"date-time":"2023-01-04T16:55:37Z","timestamp":1672851337000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2022.1052338\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,4]]},"references-count":58,"alternative-id":["10.3389\/fpubh.2022.1052338"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2022.1052338","relation":{},"ISSN":["2296-2565"],"issn-type":[{"type":"electronic","value":"2296-2565"}],"subject":[],"published":{"date-parts":[[2023,1,4]]},"article-number":"1052338"}}