Abstract: Exploring the institutional innovation paths for the incentive mechanism of organ donation in our country, with "delayed rewards" and "timely compensation" as the core logic, starting from the dilemma of public goods supply and the theory of incentive compatibility, a reward system that balances ethical bottom lines and policy effectiveness is constructed. Firstly, reviewing international experiences reveals that Israel's point-based priority system, Singapore's "presumed consent + financial neutrality" model, the indirect incentive mechanism in the United States, and the family reciprocal incentive model in Japan all demonstrate a balanced institutional equilibrium between legal legitimacy and cultural compatibility. Secondly, analyzing the threefold predicaments of current incentives in our country, namely, the empty circulation of incentives, the absence of compensation and the lack of credibility. To solve the policy predicament of "establishing but difficult to implement" in organ transplantation work, this paper proposes a "institutional investment" analytical framework, emphasizing the design of dual paths of delayed reward type (future preferential treatment, point-based system) and timely compensation type (economic assistance, fund feedback) to form a positive cycle of incentives and institutional trust. Finally, this paper suggests establishing an organ donation incentive system supported by a unified point-based system, a national compensation fund and a third-party supervision system, to achieve the policy vision of "paying tribute to kindness in incentives and extending life through the system".