To investigate the current status and influencing factors of social awareness regarding organ donation among Chinese citizens, providing theoretical and empirical support for initiatives aimed at increasing citizens′ llingness to donate organs after death.

From June 2023 to December 2024, a convenience sampling survey was conducted among residents of eight cities and counties in Hubei Province. The questionnaire collected demographic information, knowledge and attitudes toward organ donation, and willingness to donate. Participants were divided into two groups based on their willingness to donate. Independent sample t-tests were used for continuous variables, and chi-square tests were used for categorical variables. Variables showing statistically significant associations in univariate analysis were further included in the binary logistic regression model.

A total of 1, 432 questionnaires were collected, with 112 invalid responses excluded after data cleaning, resulting in 1, 320 valid responses for analyzed. Only 252 (19.1%) of participants expressed willingness to postmortem organ donation. Logistic regression showed that education level, recognition of legal issues surrounding donation, approval of China′s legal framework for donation, discomfort with the idea of postmortem donation, and concern about potential withdrawal of treatment independently influenced willingness.

Public willingness to donate organs remains generally low. Enhancing public awareness of organ donation laws and processes, fostering trust in the donation system, actively promoting the social value of organ donation, and addressing public concerns may effectively improve organ donation rates per million population in China.