Dying Immigrant Denied Kidney Transplant Because He Is Undocumented

Jesus Navarro, a dialysis patient who will die without a kidney transplant, has private insurance. He has a donor to provide the needed kidney. But because he is an undocumented immigrant, hospital administrators at UC San Francisco Medical Center are refusing to allow the procedure, saying that there is no guarantee Navarro will receive the necessary follow-up care because of his immigration status. Now, Navarro is stuck in an “ethical gray area” for the hospital. “It puts the doctors in a very awkward and torn position,” said Arthur Caplan, a bioethics professor at the University of Pennsylvania. “You come into this trying to do good and find yourself stuck in the middle of a fight about immigration.”

For eight years, Navarro has used a home dialysis machine to cleanse his blood after his kidneys began to fail. He reached the top of the waitlist for a kidney in the spring, but doctors called off his transplant when they discovered his immigration status. Even after his wife offered her kidney for the transplant, administrators still refused to allow the surgery. Reece Fawley, executive director of transplantation at UC San Francisco, said in a statement that the hospital considers socioeconomic stability for all patients, including immigration status.

Navarro’s situation highlights a dilemma for hospitals when it comes to organ transplants for immigrants, especially if their undocumented status threatens their continued access to insurance:

Though no data are available, anecdotal evidence suggests clinics sometimes perform organ transplants on illegal immigrants, especially when the patients are young. In one high-profile case, UCLA Medical Center gave an undocumented woman three liver transplants before she turned 21.

But health administrators also reject patients because of their immigration status, though that usually happens when the patients lack insurance. Bellevue Hospital in New York attracted attention last year when it refused to transplant a kidney between brothers because they could not pay for the operation. [...]

Some bioethicists say the hospital should have performed the surgery because Navarro would not be taking resources away from other patients or putting his wife at serious risk.

After all, many legal residents fail to follow their post-surgical plan.

Some lawmakers would even want hospitals to check the immigration status for all patients. The Arizona legislature considered a bill that would require that, and Rep. Steve King (R-IA) said in November that it would not be going “too far” to have hospitals ask patients about their immigration status.

But in the meantime, Navarro’s private insurance from his job would cover the transplant and follow-up care, but he lost job last month after an immigration audit and his insurance could run out. If he is unable to extend his insurance and ends up in California’s Medi-Cal program, his problem would worsen because Medi-Cal would not cover the immunosuppressive drugs that prevent organ rejection after a transplant. “We don’t know what to do,” his wife said. “It’s like we’re on a ledge — we can’t go here or there.”