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In the United States, more than 103,000 people are in need of a lifesaving organ transplant, yet only 23,286 people, both deceased and living, donated an organ in 2023. The vast majority of candidates on the list need a kidney, but tragically, 12 of them die every day waiting for one.

“It’s really a market-controlled process,” says Tonya Williams Bradford, associate professor of marketing and inclusive excellence term chair professor at the UCI Paul Merage School of Business. “Despite there being eight possible transplants from every healthy individual who passes away, there remains more demand than supply.”

In a study published in the Journal of Marketing, Bradford and her coauthor Naja Williams Boyd set out to discover how this supply-demand problem might be addressed in part with the right marketing mix—product, price, promotion, place, process and people—that motivates individuals to consider supporting the missions of nonprofit organizations. Specifically, they explored how the experiences of sacrifice play out for individuals participating in living organ donation.

“I am a living organ donor myself, so I am personally familiar with the many challenges both donors and recipients face,” says Bradford. “As a researcher, I believe there is a marketplace solution for many of these challenges.” In fact, the donation experience for Bradford goes beyond personal and professional into familial—she donated a kidney to her coauthor who is also her sister.

Through their own experiences, as well as the ethnographic data obtained from semi-directed phenomenological interviews of 20 living organ donors, the authors found that a carefully curated marketing mix may help mitigate experiences of sacrifice among donors, thereby overcoming consumer reluctance to donate. This is key because notions of sacrifice are not easy to capture or quantify.

“Most research focuses on the monetary sacrifices associated with charitable giving, but that’s not the only sacrifice, and for organ donation, it’s not even the most challenging,” Bradford explains. “Rather, it’s the mental, emotional and physical sacrifices of donation that have the biggest impact on the donor.”

According to the United Network for Organ Sharing, there were approximately 16,000 deceased donors in 2023 but only 6,900 living donors. As the process for consent for living donation is typically less emotionally charged than for deceased donation, it is worthwhile for organizations to find ways to increase the number of living donors. In particular, the loved ones of potential deceased organ donors are faced with an unexpected and often traumatic death. Further, deceased donors need to be exceptionally healthy, which leaves organ procurement organizations with a limited number of donation candidates. And not only the deceased person’s wishes must be considered; the remaining family members have a say in whether donation will occur.

“One of the biggest challenges for deceased organ donation is that time is of the essence,” says Bradford. “It is necessary to respect the grieving family while also keeping the organ viable. Keep in mind that deceased donors have usually died suddenly and tragically—often at a young age. If the message from the organ procurement organization is simply, ‘This is a great opportunity to help another person stay alive,’ that will feel like a cold splash to the face of a family whose loved one is suddenly and unexpectedly no longer alive.”

That’s not to say living donation isn’t emotionally and relationally complicated. Family and friends of a living donor have opinions and preferences as well. For instance, one research participant in Bradford’s study ended a long-time relationship with a partner who questioned his desire to donate an organ. On top of that, living donors wrestle with concerns about how their own bodies will function after donation, whether the transplant will successfully improve quality of life and longevity for the recipient, and the possibility of surgical complications.

Procurement organizations primarily rely on promotion to raise awareness about the donation opportunity generally—and organ procurement specialists when potential donors are deliberating over these concerns. Bradford’s research suggests these organizations have an opportunity to more fully address the donation, transplantation and recovery experience. Donors need to have both the information to fully consider the benefits and risks for themselves, the recipient and their families, and the support from the transplant center to navigate the experience.

Marketing efforts that focus only on the opportunity to donate miss an opportunity to include important messaging about the psychological and relational sacrifices a donor makes. According to this study, organizations can reduce the weight of these sacrifices through careful planning for, facilitation of and communication about the full spectrum of experiences that occur before, during and after donation.

To do this, the study identifies steps organizations can take to make use of the marketing mix in addressing each of the three types of sacrifice involved in the donation process: psychic, pecuniary and physical. In particular, organizations must understand the full extent of what they ask of donors and how those donors may experience the three types of sacrifice. That understanding allows organizations to strategically employ the six marketing-mix components to foster an environment in which people feel their donations are valued and respected to an extent commensurate with their sacrifices.

“It continues to surprise me how little support there is for donors because organ procurement organizations haven’t fully untangled the complexities of sacrifice,” Bradford says. “Oftentimes the staff interacting with donors are nurses and doctors who are very good at keeping people alive and may be focused on the possibilities due to organ donation. Such conversations may not also take into account the various sacrifices involved to agree to be an organ donor. With our research, we want to change that. We want staff to be well equipped and confident when talking to donors and families about the full range of experiences within donation and its accompanying sacrifices.”

Bradford is a big believer in what has been described as marketing for good. She wants marketers and the organizations they serve to have an opportunity to improve what’s happening in society and in particular the well-being of individuals. In this case, that means elevating the stories of organ donors and recipients so they’re more visible and consequential.

“It breaks my heart that people die because an organ isn’t donated in time to save them, and I think having better ways to identify and recruit potential donors is a key part of the solution,” explains Bradford. “Most of the donors and recipients I’ve talked to really want their story told, even those who had less than ideal outcomes. They want people to understand the complete scope of the donation experience so future donors can make informed choices.”

In subsequent research, Bradford wants to better understand how family members view the organ donation of a deceased loved one and how those perspectives can influence marketing efforts. She is currently working on a study centering experiences of families who donated the organs of their deceased loved ones to determine how marketing may elevate stories of healing and hope. Bradford realizes these stories will not bring their loved ones back. However, early findings show that deceased organ donation provides a source of hope through the transformation of a tragic death into one that leads to prolonged lives for others.

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Tonya Williams Bradford is an associate professor of marketing and the inclusive excellence term chair professor at the UCI Paul Merage School of Business. Her research focuses on rituals and identity across phenomena, including gifting, relationships with money, communities, acculturation and consumer-brand relationships. She also serves as associate editor for the Journal of the Academy of Marketing Science, Journal of Public Policy & Marketing and the Journal of Retailing and as a member of the editorial review board for the Journal of Marketing, the Journal of Consumer Research and the Journal of Consumer Psychology.