Are American transplant centers willing to transplant prisoners.

Abstract

Introduction: The United Network for Organ Sharing (UNOS) is tasked with ensuring fair and equitable access to organs for patients seeking transplant. Despite UNOS' position statement clearly stating that prisoner status should not preclude transplant evaluation, prisoners continue to face significant barriers. The goal of this survey was to discover how many American transplant centers are willing to evaluate, list, and transplant prisoners.

Materials and methods: All adult kidney transplant centers listed as active on the UNOS website were contacted to participate in a survey asking if they were willing to evaluate, list, and transplant prisoners, and why or why not.

Results: A total of 122 centers responded. Forty-nine were willing to evaluate, 43 willing to list, and 42 willing to transplant prisoners. Fourteen centers said yes, but on a case-by-case basis only. Things they reported considering were type of crime, length of sentence, and likelihood of release. Frequently cited reasons for not treating inmates were: inadequate follow up (28), insurance/funding (16), transportation (12), medication compliance (9), security (8), patient safety (8), and lack of social support (5). Twenty-four centers refused to disclose their policy or did not have one.

Conclusions: Prisoners continue to face barriers to evaluation, listing, and receiving kidney transplants. A lack of understanding of contraindications to transplant or a lack of knowledge about the prisoner system on behalf of transplant centers may contribute to these barriers. We feel as transplant professionals it is our responsibility to assist vulnerable patients in overcoming barriers to transplantation and work to ensure equitable access to organs, regardless of prisoner status.