Introduction: Emergency life-saving technicians (ELSTs), who are certified specialists trained for prehospital emergency care in Japan, are the principal decision maker to provide medical care to severely neurologically damaged patients. The aim of this study is to clarify of awareness and attitude of ELSTs toward organ transplantation and donation.

Method: In the present study, a web based questionnaire was originally designed for ESLTs in a certain prefecture in Japan containing questions about awareness of organ transplantation and donation itself and donor cards, and administered to all 345 ESLTs who worked in the fire departments, which are currently main emergent service in Japan, in a certain prefecture. Submission of this questionnaire indicated the subject’s consent to participate in the study. Valid responses were obtained from 144 (42%) participants.

Results: 58 (40.3%) had an interest in organ transplantation and donation, but 21 (14.6%) had no interest and the others (45.1%) didn’t make decision. Their interest rate in organ transplantation and donation was lower than that of normal public (65.5%) reported by the national survey conducted by the Cabinet Office in 2021. 96 (66.7%) recognized that the symbol of organ transplantation was green ribbon and 138 (95.5%) recognized the donor card delivered by Japan Organ Transplantation Network. Most participants recognized the method to present their living willingness to donate their organs, such as a driver license (87.5％) and a donor card (77.1%). Possession rate of their own donor card in the participants was 21.5%, which was greater than that of the normal public (13.3%). The rate of participants who found a patient’s donor card during daily prehospital emergency care, was 16.5%, which was greater than that the possession rate of normal public reported by national survey (13.3%). Regarding education experience, only 18 (12.6％) received professional education at the training program for in-hospital transplant procurement coordinators organized by the prefectural procurement coordinator in 4 and training schools or colleges in 10. This rate was greater than that of national pubic (5%) but lower than other medical staffs, such as physicians and nurses. 56 (39.2%) wanted to have an opportunity to learn organ transplantation and donation, but 15 (10.5%) didn’t and the others (50.3%) didn’t make decision.

Conclusion: Although the possession rate of their own donor card was greater than normal publics, the interest rate in organ transplantation and donation in participants were lower than normal publics, probably because they had little opportunities to learn organ transplantation and donation before and after becoming ELSTs. To improve their awareness and attitude towards organ transplantation and donation, we need to establish education program of organ transplantation and donation for ELSTs and increase opportunity for them to learn organ transplantation and donation.