A transplant always is a life altering change. You'll be on immunosuppressants for the rest of your life which has a massive impact on your quality of life - and that's _if_ you get a transplant before you die.

I have no idea how I'd react in that situation - but I can understand people who'd rather not. Especially considering that you might not want to take one of the few organs from a person who might be willing to fully commit to that.