UCSF: Give Mr. Navarro his Kidney Transplant

Dear Friends,

We are contacting you today to ask for your immediate support.

Jesus Navarro, a recently laid off Pacific Steel Worker, was denied a Kidney Transplant by UC San Francisco Medical Center citing his undocumented status. He had insurance, a donor who is his wife, and was next on the waiting list. Since the story broke (at the bottom of the email), organizations and concerned and outraged individuals have come forward to support Mr. Navarro and his family.

On behalf of ACUDIR (Alameda County United in Defense of Immigrant Rights) and the Pacific Steel Worker Committee,  we are asking you to: Take a stand for justice and demand that UCSF Immediately provide the Kidney Transplant Treatment and all Subsequent Necessary Care to Jesus Navarro, and to Stop Using Immigration Status as a Basis for Denying Care to Any Patient. His life and the lives of hundreds depend on this.

We are sending the letter to UCSF tomorrow at Noon and would like your signatures no later than 11am. Please email your organizational and/or individual sign on to cinthya@cjjc.org

Thanks for your support.





Susan Desmond-Hellmann, Chancellor

Reece Fawley, executive director of transplantation

University of California at San Francisco

Sherry Lansing, Chair

University of California Board of Regents


We Demand that UCSF Immediately Provide Transplant Treatment and all Subsequent Necessary Care to Jesus Navarro, and to Stop Using Immigration Status as a Basis for Denying Care to Any Patient

TWe, the undersigned, express our outrage that UCSF has used the immigration status of Jesus Navarro to deny him transplant services needed to save his life, and for which he is clearly eligible.  This is a basic violation of his human rights, essentially condemning him to die because of his immigration status.

People have a right to medical care, regardless of immigration status.  It is unacceptable to our community that you deny care on this basis, especially because the death of Mr. Navarro is a likely consequence of it. Your actions violate international human rights law, and the sanctuary policy and other measures passed by the city of San Francisco, in which your center is located, which call for human rights and equality of treatment for all people, regardless of immigration status.

Our community, which supports the UC system through the taxes we pay, stands for equality and human rights for all people who live here, regardless of immigration status.  You are a public institution, and we hold you accountable to our community for this outrageous action.

We demand that you immediately provide the necessary transplant needed by Mr. Navarro.  Because your actions have inexcusably delayed his treatment, and as a result, he may lose his medical insurance during the time of recovery, we further demand that you provide all follow-up care and needed medicine, regardless of whether the cost is covered by medical insurance.

We further demand that you make a public statement that you will no longer ask any patient about their immigration status, that you will no longer deny care based on immigration status, and that you will take affirmative steps to ensure that all patients at UCSF are treated equally without regard to their nationality or immigration status.





No kidney transplant for dying East Bay dad who is illegal immigrant

By Hannah Dreier
Contra Costa Times
Posted:   01/30/2012 04:15:22 PM PST
Updated:   01/31/2012 07:12:41 AM PST

Immigration status complicates transplant
Jesus Navarro, an undocumented immigrant from Mexico, dons a surgical mask to prevent infection while connecting to a machine to start his daily home dialysis treatment, Monday, Jan. 9, 2012, in Oakland, Calif. (D. Ross Cameron/Staff)

  • Without a new kidney, Jesus Navarro will die.
The Oakland man has a willing donor and private insurance to pay for the transplant. But he faces what may be an insurmountable hurdle in the race to save his life: He is an illegal immigrant.

Administrators at UC San Francisco Medical Center are refusing to transplant a kidney from Navarro’s wife, saying there is no guarantee he will receive adequate follow-up care, given his uncertain status.

Their decision is a stark illustration of the tension between health care and immigration policies in the state and underscores the difficult role medical professionals play in trying to save the lives of undocumented residents.

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.

It is the kind of ethical gray area that hospitals hate, said University of Pennsylvania bioethics professor Arthur Caplan.

“It puts the doctors in a very awkward and torn position,” he said. “You come into this trying to do good and find yourself stuck in the middle of a fight about immigration.”

Immigrant advocates and some scholars say it is wrong for hospitals to withhold health care from the seriously ill, no matter their legal status.

But proponents of tougher border enforcement — and those fighting to contain ballooning health care costs — fear that providing such services could lure more undocumented immigrants.

Navarro, 35, never thought his survival would hinge on his immigration status. He has had private insurance through Berkeley’s Pacific Steel foundry for 14 years.

When his kidneys began to shut down eight years ago, he continued to work full time. Each evening, he would cleanse his blood of lethal toxins using a home dialysis machine.

But the soft-spoken metalworker has been growing sicker. Life expectancy for dialysis patients hovers around six years.

This spring, the family got a call from UCSF’s transplant center: Navarro had reached the top of the waitlist.

“We were so happy,” recalled his wife, who went with him for the final work-up.

But in their final consultation before the surgery, Navarro says doctors discovered his immigration status and called off the operation.

“I started crying and crying and crying,” said his wife, who asked that her name be withheld because she is also in the country illegally. She offered her own kidney — and was a match — but administrators again said no.

UCSF declined to comment on Navarro’s case, but Executive Director of Transplantation Reece Fawley said in a statement that the clinic evaluates all patients for socioeconomic stability.

“UCSF’s policy for financial clearance requires candidates to present evidence of adequate and stable insurance coverage or other financial sources necessary to sustain follow-up care long after transplant surgery,” she said. “Immigration status is among many factors taken into consideration.”

Navarro was caught up in an immigration audit and lost his foundry job earlier this month. His private insurance continues for now, and he is trying to extend it. But he may well end up on the state’s Medi-Cal program.

That would deepen Navarro’s dilemma. While Medi-Cal will cover his daily dialysis — which now costs $17,000 a month — because of his illegal status, it will not pay for the immunosuppressive drugs that ward off organ rejection. The drugs cost $20,000 annually. Medi-Cal also won’t pay for organ transplants for illegal immigrants.

The hospital won’t perform the transplant without a guarantee that the drugs and accompanying treatment will be paid for.

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.

“Why was this patient denied the opportunity to comply?” asked Santa Clara University bioethics professor Margaret McLean.

Other experts suggest that the possibility of saving a life should outweigh concerns about follow-up care.

“He has the organ — the critical resource — if he can get it transplanted,” said University of Southern California bioethics professor Michael Shapiro. “That’s a serious chance at life.”

But critics say that providing any long-term care to illegal immigrants is irresponsible and discourages home countries from investing in an adequate health system.

“You just cannot provide care for illegal aliens without getting into uncompensated care,” said Bob Dane of the Federation for American Immigration Reform.

Navarro says his chief concern is finding a new job, not the quest to save his life. But he also worries for his family and takes anti-anxiety pills to sleep.

If transplant doctors working with illegal immigrants are in a bind, so are the Navarros.

“We don’t know what to do,” said Navarro’s wife, watching her husband chase after their 3-year-old daughter. “It’s like we’re on a ledge — we can’t go here or there.”

Contact Hannah Dreier at 510-262-2787. Follow her at Twitter.com/hannahdreier

Increased regulation on the horizon
The nonprofit group that manages the nation’s organ transplant system is considering increasing its oversight of transplants to noncitizens.
The United Network for Organ Sharing currently does not limit the percentage of organs that clinics can transplant to immigrants. That is partly because nonresidents donate more organs than they receive.
Over a 20-year period, illegal immigrants donated 2.5 percent of organs and received fewer than 1 percent, according to a 2008 study published by the American Medical Association.
The network reserves the right to audit the rare clinic that gives more than 5 percent of organs to nonresident patients. The concern is that a transplant center might start bringing in wealthy “transplant tourists” from other countries to make money.
“Regardless of our policy, it is always the decision of any transplant center,” said network spokesman Joel Newman.
The organization is considering a new rule that would require clinics to provide detailed accounts of the immigrants they serve and allow the organization to review all nonresident transplants.
The goal would be to distinguish patients traveling to the United States for a transplant from those noncitizens who live in the country and thus are more likely to donate organs to U.S. citizens.
— Hannah Dreier