Study Reveals Challenges and Opportunities in Organ Donation and Transplantation for Non-US Citizens

The population of non-US citizens and residents (NCNR) is one of a kind and on the rise. This subgroup’s patterns of heart donation and heart transplant (HT) have not been fully described. The study’s objective was to assess the characteristics and outcomes of NCNR HT recipients and the utilization of organs from NCNR donors.

All adult donors whose hearts were recuperated for HT and all essential adult HT recipients from 2013-2020 were recognized involving the United Network for Organ Sharing (UNOS). Citizens, residents, or NCNR were the categories used to classify donors and recipients. The reason for travel to the United States was used to further classify non-residents and non-citizens. One year after transplantation, outcomes included rejection, infection, and mortality.

NCNR represented 0.4% (n = 77) of heart donors. The majority of NCNR donors (61%) were Hispanic, most of whom were recovered from the South and Southwest of the United States. Compared to citizens and residents, donors were less likely to provide written documentation that they were donors. 0.7% (n = 147) of all HT recipients were NCNR. The majority identified as non-Hispanic White people (57.1%). NCNR recipients appeared sicker than citizens and residents, as evidenced by higher priority UNOS status and higher IABP utilization prior to HT. For HT, 63% of NCNR recipients traveled to the United States, with Kuwait (29.9%) and Saudi Arabia (21%) accounting for the majority. There were no differences between the groups in terms of mortality, infection, or rejection one year after the transplant.

A developing subgroup of NCNR travel from nations with low HT rates to the US for HT. This emphasizes the necessity of methods to increase equitable access to HT both domestically and internationally.