WASHINGTON — Americans for Safe Access’s new report, Stigma with a Body Count: Medical Cannabis & Organ Transplant Policy, documents how medical cannabis patients continue to face reduced access to transplant evaluation, waitlisting, and life-saving organ transplantation despite growing clinical evidence that cannabis exposure alone does not predict poor transplant outcomes.
The report comes ten years after California enacted the nation’s first law prohibiting denial of transplant-related services solely on the basis of lawful medical cannabis use. Yet ASA’s findings show that transplant eligibility is still too often shaped by institutional bias, inconsistent program practices, and outdated assumptions rather than individualized medical evidence.
“Patients are still being judged on outdated assumptions about cannabis medicines instead of being evaluated as individuals with the best available medical evidence,” said ASA Executive Director Steph Sherer. “This report shows that the consequences of that bias are not abstract. They can mean delayed evaluation, denial of care, and death.”
The report reviews current research on kidney, liver, heart, and lung transplantation and finds that the available literature has not identified clear outcome penalties associated with cannabis exposure alone. It also documents evidence that patients who use cannabis may face lower listing rates, longer delays in evaluation, and inconsistent treatment across transplant programs, even when clinical outcomes do not justify exclusion.
ASA says the issue remains urgent because the discrimination is ongoing. The report revisits the case of Norman Smith, a California patient with liver cancer whose removal from the transplant waiting list helped expose the issue more than a decade ago, and highlights the current case of Patrick Navarro, a critically ill patient at the University of California, San Francisco (UCSF), whose family is fighting for reconsideration of a written lung-transplant denial that cited long-term marijuana use as the reason for exclusion.
On March 5, 2026, Patrick received written notice that UCSF had declined him for lung transplantation. The reason provided to the family was explicit: “long-term marijuana use raising concerns regarding the ability to maintain durable abstinence after lung transplant.”
“We came to UCSF because of its reputation for post-transplant success and its ability to take on the sickest patients, giving them a chance at life. Patrick has told me he wants to live, and I will keep fighting for him. I know this is where he needs to be,” said Cindy Navarro, his mother. “The denial was devastating, but the explanations that followed have been confusing and painful. If these concerns were already known, why was Patrick put through so much suffering? I need the facts, and I need to know that Patrick is being evaluated fairly so I can advocate for him accordingly.”
California law exists precisely to prevent lawful medical cannabis use from serving as the sole basis for denying transplant-related services. It matters because Patrick’s other serious medical complications were already known to the transplant team before the written denial was issued.
“Norman Smith’s case helped change California law, but Patrick Navarro’s case shows that the problem is far from over,” Sherer said.
According to the report, transplant clinicians often cite concerns about microbial contamination of inhaled cannabis products, possible drug interactions with immunosuppressants such as tacrolimus, and adherence to post-transplant treatment. But ASA argues that these are specific, manageable clinical issues that should be addressed through monitoring, patient education, and product safety standards. This is in line with policy statements from national and international organ transplant organizations that are calling for individualized review when it comes to candidates and medical cannabis, not blanket exclusion.
The report also outlines a set of policy recommendations, including national evidence-based guidance for transplant candidacy, protections against denial based solely on lawful medical cannabis use, standardized transplant evaluation practices, better product safety and counseling, therapeutic monitoring of drug interactions, expanded research and data collection, reform of cannabis use disorder frameworks to distinguish medical use, and education for transplant clinics on cannabis medicines as a potential therapeutic option in carefully selected patients.
ASA urges patients and families who believe they have been denied transplant evaluation, waitlisting, or transplant-related services because of lawful medical cannabis use to contact the organization.
“We know that patients are still being judged through stigma instead of science. No patient or family should have to navigate this alone,” Sherer said. “If you or a family member has experienced transplant discrimination related to medical cannabis, contact ASA. We want to hear from you, document these cases, and continue this fight so stigma does not decide who gets a chance to live.”Patients and families experiencing transplant discrimination related to medical cannabis are encouraged to contact Americans for Safe Access by filling out the organ transplant discrimination intake form.
