Every day, lives are saved in the United States thanks to organ transplants. But the intersection of organ transplants and immigration status raises serious concerns. For some people, especially undocumented immigrants or non-U.S. citizens, getting on the transplant list can feel like an impossible dream.
There are an estimated 11 million undocumented individuals living in the U.S., yet we don’t know how many of them need organ transplants. That lack of data is part of the problem. And although federal law says that only medical criteria should be used when deciding who gets a life-saving organ, in reality, organ transplants and immigration status remain closely intertwined.
What the Law Says vs. What Happens
Back in 1984, the National Organ Transplantation Act (NOTA) made it clear: only medical need should determine who gets a transplant. But since then, the actual policies have gotten murkier.
The Organ Procurement and Transplantation Network (OPTN)—which oversees organ donation and transplantation in the U.S.—still requires transplant centers to collect information about each patient’s citizenship and residency status. That’s despite the law’s intention to keep non-medical factors out of the equation, keeping organ transplants and immigration status separated in theory, but not always in practice.
A History of Unequal Treatment
Let’s rewind a bit:
- 1986: OPTN recommended that no more than 10% of kidney transplants at any center go to non-U.S. citizens, including both residents and non-residents.
- 1994: The cap dropped to 5% for all organs. If a center went over that limit, they risked being audited, though audits were never actually carried out.
Result? Many transplant centers became hesitant to serve patients with unclear immigration status, putting organ transplants and immigration status into a tense relationship that created real barriers to lifesaving care for undocumented people.
Global Backlash and the Declaration of Istanbul
As the issue gained international attention, the World Health Organization (WHO) called on countries to protect vulnerable populations and stop unethical “transplant tourism”, where people travel to another country for transplants, sometimes in unethical ways.
In 2008, 150 experts from around the world came together and created the Declaration of Istanbul, which defined transplant tourism as any situation where foreign patients are prioritized over the local population, or where organ trafficking or commercialization is involved.
Breaking Down OPTN’s Current Policies
OPTN has updated its categories over time to better reflect the patient population. Since 2011, the system now distinguishes between:
- Non-U.S. Citizen/U.S. Resident (someone living in the U.S. without citizenship)
- Non-U.S. Citizen/Non-U.S. Resident (someone traveling to the U.S., either for a transplant or other reasons)
The categories are based on two questions:
- Are you a U.S. citizen?
- Is the U.S. your permanent home?
Interestingly, OPTN does not ask for your specific immigration status; they don’t know if someone is undocumented, on a visa, or has DACA. This can lead to inconsistent data and potential bias in how transplant decisions are made.
Growing Concerns About Proof of Status
Recent reports show that some hospitals require proof of lawful presence before accepting transplant patients. This practice isn’t universal and varies by state and hospital system. In California, for instance, legislation has been introduced to ban such policies and ensure that immigration status isn’t used to deny lifesaving treatment. As the national conversation continues, transparency in how these policies are enforced is critical. Advocates urge health systems and lawmakers to clarify guidelines and ensure fair treatment for all patients, regardless of status.
Why This Matters
Imagine needing a kidney transplant and being told you don’t qualify not because of your health, but because of where you were born or how you got to the U.S.. It’s not just unfair, it’s dangerous. The intersection of organ transplants and immigration status has real-life consequences. Delays in care or outright denial of a transplant can mean the difference between life and death.
And yet, many undocumented individuals contribute to the system by working essential jobs, paying taxes, and even registering as organ donors. But when they need help, the system may not help them in return.
Time for Reform
Advocates and medical experts agree: we need transparency, equity, and consistency when it comes to organ transplants and immigration status. That includes:
- Making sure immigration status is not a barrier
- Improving transparency and consistency in how transplant centers collect and use residency data
- Upholding the principle that a human life is worth saving, regardless of citizenship
As a country, we need to ask ourselves: Are we doing enough to protect the most vulnerable among us? Because when it comes to organ transplants, every life should count equally.
Need Help Understanding Your Rights as an Immigrant Patient?
At Qazi Law Offices, we believe every person deserves the chance to live, thrive, and access lifesaving care regardless of status. Whether you’re navigating hospital policies or fearful that your status will affect your treatment, we’re here for you. Your life and the lives of your loved ones matter.
📞 Call us today at 630-504-0648 or schedule a confidential consultation with Attorney Farrah.
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