Immigrant organ transplants in the United States have become a hot topic since the news of the botched heart-lung transplant surgery of Jesica Santiallan, a young girl from Mexico died. Doctors at Duke University Medical Center in North Carolina performed the surgery. The controversy concerning organ transplants and foreigners initially surfaced in the 1980’s, and involves a mixture of politics, nationality and medicine that has the transplants networks like the United Network for Organ Sharing (UNOS), and groups who favor restricting immigration, like North Carolina Listens. Immigration advocates argue that U. S. citizens are more likely to benefit from organs donated by noncitizens than the reverse. In 2001, U.S. citizens received 96.2 percent of the transplants in the country while 94.8 percent of the organ donors were citizens. This has been the constant trend for more than a decade according to the UNOS.

UNOS, the non-profit group that coordinates the nation’s transplant system linking organ donors with recipients nationwide, has a policy that imposes a limit on the number of organs that can be transplanted to foreigners in a given year. A center may not transplant more than 5 percent of organs to immigrants, but there is no limit to the number of organs a noncitizen may donate. Hospitals have the discretion to put foreign citizens, including illegal immigrants, on the national waiting list for transplants. From 1998 to 2001, organ donations from foreign residents increased from 0.1 to 2.8. This progress in organ donations is likely a result of outreach efforts to encourage donations, particularly in the Hispanic community.

At Duke University Medical Center, 2,541 people have received organ transplants at Duke from 1998 to 2002, there were no nonresident noncitizens recorded. But with more than 80,000 people on a national waiting list and more than 5,500 people dying each year before they can receive transplants, the question still lingers about whether foreigners should have the same access to the nation’s limited pool of donated organs. Ron Woodard, the president of North Carolina Listens, while commenting on the sadness of the Santillan situation, said that if he was on the waiting list his thought would be, “Why were organs given to someone who was here illegally?” Joel Newman, UNOS spokesman says, “Part of the rationale is that it may be hypocritical to accept donors who are not U.S. citizens, but not allow them to be transplant recipients.”

There are groups that believe that US citizens should be given priority in receiving transplants. But immigrant advocates point out that national data for 2001 shows 2 percent of the total donors were foreigners who died in the United States while just 1 percent of transplants went to foreign recipients. Immigration restrictionist groups also argue that the medical expenses of transplants and related care for illegal immigrants with no health insurance and who cannot pay are a burden to hospitals, U.S. taxpayers and insured patients. Jesica Santiallan, however, received no government funds, had 80 percent of her medical expenses paid by the her mother's employer's insurance plan and the balance was covered by the foundation established by the family’s benefactor. The government has long stopped reimbursing hospitals for transplants for illegal immigrants.