Knowledge and attitudes toward organ donation and transplantation among medical students in Greece: A cross-sectional survey.

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.