Background: Early liver transplantation (ELT) describes liver transplantation (LT) for alcohol-related liver disease (ALD) performed before 6 months of alcohol abstinence, commonly known as the "6-month rule." Although recent evidence demonstrates favorable outcomes after ELT, concern that the public may withdraw from organ donation if ELT grows as a practice is underexplored empirically. We sought to investigate desire to donate after exposure to information about ELT.

Methods: We designed a public perception survey using expert feedback, cognitive interviewing, and pilot testing. We used quota-based sampling based on US national demographics and distributed the survey from November 15, 2023 to January 10, 2024 using Qualtrics research services.

Results: Of 2032 respondents who completed the survey, 57.4% of respondents reported being registered organ donors or specifying an intent to donate in a living will. After learning about ELT, 61.0% of respondents expressed agreement with ELT, a similar proportion to those who expressed agreement with LT for ALD without being given prior information (64.1%). In response to information that some centers do not require the 6-month alcohol-free period, 55.7% of respondents indicated they wanted to be an organ donor, 15.5% did not want to be a donor, and 28.8% were unsure. Of the respondents who stated they were organ donors, 82.9% reported a desire to be organ donors after exposure to information about ELT.

Conclusion: Public perceptions of ELT do not appear substantially different from perceptions regarding LT for ALD. Our findings do not support concerns about widespread public withdrawal from organ donation due to ELT.