A Colorado kidney transplant candidate who was bumped to inactive status for failing to get vaccinated against Covid-19 has become the most public example of an argument roiling the country's more than 250 organ transplant centers. Across the country, growing numbers of transplant programs have chosen to either bar patients who refuse to take the widely available Covid vaccines from receiving transplants or to give them lower priority on crowded organ waitlists. Other programs, however, say they plan no such restrictions — for now. At issue is whether transplant patients who refuse the jabs are not only putting themselves at greater risk for serious illness and death from Covid infections, but also squandering scarce organs that could benefit others. The argument echoes the demands that smokers quit cigarettes for six months before they receive lung transplants or that addicts refrain from alcohol and drugs before they receive new livers. "It is a matter of active debate," said Dr. Deepali Kumar, an expert in transplant infectious diseases at the University of Toronto and president-elect of the American Society of Transplantation. "It's really an individual program decision. In many programs, it's in flux." Leilani Lutali, 56, a late-stage kidney disease patient from Colorado Springs, Colorado, learned in a Sept. 28 letter from UCHealth in Denver that if she didn't begin a Covid vaccine series within 30 days, she would lose her spot on the transplant waiting list. Both she and her donor, Jaimee Fougner, 45, of Peyton, Colorado, refused to get vaccinated, citing religious objections and uncertainty about the safety and effectiveness of the vaccines. "I have too many questions that remain unanswered at this point. I feel like I'm being coerced into not being able to wait and see and that I have to take the shot if I want this lifesaving transplant," Lutali said. She said she offered to be tested for Covid before the surgery or to sign a waiver absolving the hospital of legal risk for her refusal of a vaccine. "At what point do you no longer become a partner in your own care regardless of your own concerns?" she said.