Supporting organ transplantation in non-resident aliens within limits

It is common knowledge that the supply of cadaveric organs does not meet demand. This shortage is often used as ethical argument against transplantation in Non-Resident Aliens; however, this fact in isolation does not present a comprehensive picture of organ allocation in USA. Even though approximately 153 cadaveric livers, kidneys, and hearts are transplanted into Non-Resident Aliens each year, roughly another 85 livers, kidneys and hearts are recovered as usable for transplantation but are not transplanted due to inability to find a recipient. These organs are also unable to be exported due to logistics or lack of patient matching. Because usable, recovered allografts are discarded on a yearly basis, there is no justification to use "allograft scarcity" as argument against transplantation in Non-Resident Aliens. Further, consistent with other countries, a system of two waiting lists which allocates organs to US Residents with the first right of refusal (with Non-Resident Aliens having to access organs refused by or not matched to US Residents) is ethically appropriate. Justification for this two-list system lies in deconstructing "who" is the transplant community, and who are "guests" of the transplant community.