Impact and Implications of Solid Organ Transplant of Undocumented Immigrants versus Transplant Tourists on the Transplant Center and OPTN National Policy Development

The Organ Procurement and Transplantation Network (OPTN) governs the transplant policy development in the United States. This review examines the impact and implications of the transplantation of undocumented immigrants and transplant tourism on the transplant center and OPTN policy.

Changes in OPTN policy have moved the needle towards more equitable access to transplantation for non-citizens in the US while limiting transplant tourism. However, there remains a lack of clarity for transplant centers, in addition to multiple other systemic and structural barriers, which may contribute to inequitable access to care for non-citizens.

We highlight the evolution of OPTN policy for non-citizen transplantation and its effect on equitable organ allocation while addressing concerns over transplant tourism. Despite this, there is an additional need for clarity in citizenship and residency definitions at the policy level, and improved education and policy adjustments within transplant centers to enhance access for non-citizens.