Transplantation Outcomes Among Non-Citizens in the United States: A Scoping Review

This record contains the protocol for a scoping review, "Transplantation Outcomes Among Non-Citizens in the United States." OPTN policy allows non-U.S. citizens to be evaluated and listed for solid organ transplantation. Even so, gaps in insurance coverage, uncertain access to follow-up care and immunosuppression, and center-level hesitancy remain major barriers for this growing population. Studies of post-transplant outcomes in these recipients are scattered across study designs, single-center experiences, and organ types, and no review has yet brought them together. This review will map the literature on outcomes after heart, lung, kidney, and liver transplantation among non-citizens of any age in the United States. It will describe how "non-citizen" is defined, which outcomes are reported (graft and patient survival, rejection, re-transplantation, immunosuppression adherence and access, and quality of life), and which data sources are used (single-center, multi-center, and UNOS/SRTR). MEDLINE (via PubMed), Embase, and Web of Science will be searched for quantitative and qualitative primary studies. The review follows the Population–Concept–Context framework. Its findings will highlight evidence gaps to inform future research, clinical practice, and transplant policy.