Symeou S, Karageorgos FF, Markozannes G, Papalois V, Tsoulfas G. Knowledge and attitudes toward organ donation and transplantation among medical students in Greece: A cross-sectional survey. World J Transplant 2026; 16(3): 117608 [DOI: 10.5500/wjt.117608]
Corresponding Author of This Article
Georgios Tsoulfas, MD, Chief, Director, FACS, Professor, Department of Transplantation Surgery, Center for Research and Innovation in Solid Organ Transplantation, School of Medicine, Aristotle University of Thessaloniki, 49 Konstantinoupoleos Street, Thessaloniki 54642, Greece. tsoulfasg@gmail.com
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Transplantation
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research-article
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Symeou S, Karageorgos FF, Markozannes G, Papalois V, Tsoulfas G. Knowledge and attitudes toward organ donation and transplantation among medical students in Greece: A cross-sectional survey. World J Transplant 2026; 16(3): 117608 [DOI: 10.5500/wjt.117608]
Solonas Symeou, Filippos F Karageorgos, Georgios Tsoulfas, Department of Transplantation Surgery, Center for Research and Innovation in Solid Organ Transplantation, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki 54642, Greece
Georgios Markozannes, Department of Hygiene and Epidemiology, School of Medicine, University of Ioannina, Ioannina 45110, Greece
Vassilios Papalois, Imperial College Renal and Transplant Centre, Imperial College Healthcare NHS Trust, Hammersmith Hospital, London W12 0HS, United Kingdom
Vassilios Papalois, Department of Surgery and Cancer, Imperial College London, London SW7 2AZ, United Kingdom
Author contributions: Symeou S and Karageorgos FF contributed to data acquisition and drafting the manuscript; Symeou S, Karageorgos FF, and Markozannes G contributed to data acquisition analysis and interpretation; Symeou S, Karageorgos FF, Papalois V, and Tsoulfas G revised the manuscript; Symeou S, Papalois V, and Tsoulfas G conceptualized the study; Markozannes G supervised the analytical process; Papalois V and Tsoulfas G designed the study and supervised the overall study.
AI contribution statement: No part of the manuscript text was generated by AI. All content was written entirely by the authors.
Institutional review board statement: This study was reviewed and approved by the Institutional Review Board of Aristotle University of Thessaloniki (Approval No. 9/15.7.2025).
Informed consent statement: Informed consent was obtained from all participants.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: No additional data are available.
Corresponding author: Georgios Tsoulfas, MD, Chief, Director, FACS, Professor, Department of Transplantation Surgery, Center for Research and Innovation in Solid Organ Transplantation, School of Medicine, Aristotle University of Thessaloniki, 49 Konstantinoupoleos Street, Thessaloniki 54642, Greece. tsoulfasg@gmail.com
Received: December 11, 2025 Revised: February 7, 2026 Accepted: March 12, 2026 Published online: September 18, 2026 Processing time: 265 Days and 11.2 Hours
Abstract
BACKGROUND
Organ transplantation is the definitive treatment for end-stage organ failure, and the gap between organ demand and donation is still a major challenge to overcome. Several countries, including Greece, have reformed their transplant framework to increase organ donation, but the long waiting times and low donor rates point to limited public awareness and engagement. Medical students, as future physicians, have a critical role within transplantation systems, as their knowledge, attitudes and engagement will affect donor identification, the consent processes and how donation is communicated to the public.
AIM
To assess Greek medical students’ knowledge and attitudes in order to inform strategies for strengthening organ donation nationally and internationally.
METHODS
A cross-sectional online survey was conducted between July 2025 and September 2025 across all medical schools in Greece. A 38-item questionnaire covered baseline demographics, knowledge and attitudes toward organ donation and transplantation. Responses were summarized with descriptive statistics, and seven multivariable logistic regression models were used to identify predictors of key outcomes (significance at adjusted P < 0.05).
RESULTS
Among 562 respondents (mean age 21.5 years, 68.3% female), only 13.0% correctly identified all organs transplantable from deceased donors, compared with 62.0% for living donors. Misconceptions were common, and awareness of the Hellenic Transplant Organization (HTO) was limited (22.8%). While 63.4% were willing to donate posthumously, only 8.2% were registered donors. Willingness to donate during lifetime was high (95.0%) but conditional. Prior discussion with family or friends increased the likelihood of willingness for posthumous donation [odds ratio (OR) = 2.38, adjusted P < 0.001]. A preference for surgical specialties predicted the perception of living donor grafts as superior (OR = 2.15, adjusted P = 0.027), while awareness of the HTO was a strong predictor of donor card possession (OR = 6.60, adjusted P < 0.001).
CONCLUSION
Medical students in Greece exhibit strong intentions but limited engagement and mixed knowledge of organ donation. Strengthening transplant education, raising the visibility of national structures and fostering student-led advocacy are essential to converting willingness into action and building public trust.
Core Tip: As future clinicians, medical students will play a pivotal role in counseling families about organ donation. However, this study reveals significant gaps in core transplant knowledge and limited confidence in the Hellenic Transplant Organization. While willingness to donate is high, formal registration remains low, with altruism often tethered to family ties. This intention-behavior gap suggests that current medical education leaves future doctors underprepared to advocate effectively. Encouragingly, prior dialogue and institutional visibility correlate with supportive attitudes. Targeted curricular reform, institutional engagement and student-centered initiatives are therefore essential to bridge these gaps and empower the next generation of clinicians.
