SB456

Regular Session

Relating to the purchase or sale of human organs; increasing a criminal penalty.

CriticalImmediate action required

Low Cost

Effective:2025-09-01

Enforcing Agencies

Texas Medical Board • Local District Attorneys • Texas Law Enforcement Agencies

Compliance Analysis

Key implementation requirements and action items for compliance with this legislation

Implementation Timeline

Effective Date: September 1, 2025
Compliance Deadline: September 1, 2025. All procurement protocols and vendor contracts must be updated prior to this date to ensure no non-compliant organs enter the facility on Day 1.
Agency Rulemaking: The Texas Medical Board (TMB) is expected to update Chapter 190 (Disciplinary Guidelines) to reflect this mandatory revocation. Watch for proposed rules between May and August 2025 regarding the evidentiary standard for "knowing" use.

Immediate Action Plan

1. Audit Supply Chain: Immediately audit all current tissue and organ vendors for accreditation and compliance history.
2. Revise Checklists: Insert a mandatory "Legal Source Verification" step into the surgical safety checklist for all transplant procedures.
3. Update Bylaws: Amend Medical Staff Bylaws to mandate automatic suspension of privileges upon indictment for an organ trafficking offense.
4. Educate Surgeons: Conduct a mandatory briefing for all transplant surgeons regarding the mandatory license revocation provision—ensure they understand their personal license is at risk.

Operational Changes Required

Contracts

Vendor/OPO Agreements: Immediate review required. Master Services Agreements with Organ Procurement Organizations and tissue banks must include strict representations and warranties that all tissues are obtained in compliance with Texas Penal Code 48.02. Add immediate termination rights and uncapped indemnification for regulatory/criminal defense costs.
Physician Employment Agreements: Amend "Termination for Cause" definitions to explicitly include "revocation of license under Occupations Code 164.0571" and "indictment for violation of Penal Code 48.02."

Hiring/Training

Surgical "Time Out" Protocols: Update pre-operative checklists. The transplant team must verbally verify the organ's Chain of Custody documentation before anesthesia induction.
Procurement Staff Training: Receiving staff must be trained on a "Hard Stop" policy: if the source documentation is incomplete or ambiguous, the organ cannot be accepted into inventory.

Reporting & Record-Keeping

Chain of Custody Audit Trails: Facilities must maintain a granular audit trail linking the specific patient ID to the donor source ID. This record must be retained for a minimum of 3 years (statute of limitations for State Jail Felonies), though 7 years is recommended for civil liability alignment.
EHR Integration: Update Electronic Health Records to require a "Source Verification" field entry before a transplant procedure code can be finalized.

Fees & Costs

Insurance Premiums: Expect scrutiny from malpractice carriers. Criminal acts are generally excluded from coverage; verify if your Directors & Officers (D&O) policy covers defense costs for regulatory investigations triggered by these charges.
Legal Defense: No new state fees, but the cost of defending a felony charge or license revocation is substantial and likely uninsurable.

Strategic Ambiguities & Considerations

Definition of "Knowingly": The statute requires "knowing" use for license revocation. It is unclear if the TMB will interpret "willful blindness" (failing to check paperwork) as "constructive knowledge." Until rules are published, assume the strictest standard: failure to verify documentation equals knowledge of illegality.
Scope of "Human Organ": While Penal Code 48.02 defines "human organ," ambiguity remains regarding processed tissue products (e.g., bone paste, particulate grafts) versus vascularized organs. We anticipate TMB rulemaking will need to clarify if minor tissue products trigger the same mandatory revocation as major organs.

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Legislative Timeline

This bill's path through the Texas Legislature

TopicsCrimes Crimes--against Persons Crimes--against Persons--general Criminal Procedure Criminal Procedure--sentencing & Punishment Physicians Medical Board, Texas Occupational Regulation Occupational Regulation--health Occupations

Official Analysis

View HRO Analysis View All Bill Documents

BILL ANALYSIS

Senate Research Center	S.B. 456
89R3849 JDK-D	By: Middleton
	Criminal Justice
	4/16/2025
	As Filed

AUTHOR'S / SPONSOR'S STATEMENT OF INTENT

It is estimated that trafficked organs account for up to 10 percent of organ transplants performed around the world. Profits are conservatively estimated to be between $840 million and $1.7 billion dollars annually. This is a highly profitable industry that presents a dangerous incentive to traffickers. Individuals have reported being misled, coerced, or otherwise forced into selling their organs. Strong criminal penalties have been shown to effectively deter crime.

Furthermore, Class A misdemeanors are less destructive crimes in nature. Examples of Class A misdemeanors in Texas include criminal trespass, lying under oath, online impersonation, and violating a protective order. These crimes pale in comparison to the detrimental impact of human organ trafficking.

S.B. 456 increases the penalty for purchasing or selling human organs. This bill amends Section 48.02(d) of the penal code, changing the offense from a Class A misdemeanor to a state jail felony. Further, the bill revokes the license of a physician who knowingly uses a human organ that has been trafficked or harvested.

As proposed, S.B. 456 amends current law relating to the purchase or sale of human organs and increases a criminal penalty.

RULEMAKING AUTHORITY

This bill does not expressly grant any additional rulemaking authority to a state officer, institution, or agency.

SECTION BY SECTION ANALYSIS

SECTION 1. Amends Section 48.02(d), Penal Code, as follows:

(d) Provides that an offense under Section 48.02 (Prohibition of the Purchase and Sale of Human Organs) is a state jail felony. Deletes existing text providing that a violation of this section is a Class A misdemeanor.

SECTION 2. Amends Subchapter B, Chapter 164, Occupations Code, by adding Section 164.0571, as follows:

Sec. 164.0571. REQUIRED REVOCATION OF LICENSE FOR PROCEDURE INVOLVING CERTAIN HUMAN ORGANS. Requires the Texas Medical Board to revoke the license of a physician if the physician knowingly uses a human organ obtained in violation of Section 48.02, Penal Code, in a medical procedure.

SECTION 3. Makes application of Section 48.02(d), Penal Code, as amended by this Act, prospective.

SECTION 4. Makes application of Section 164.0571, Occupations Code, as added by this Act, prospective.

SECTION 5. Effective date: September 1, 2025.

Senate Authors

Sen. Mayes MiddletonRepublican · Primary Author

Coauthors (1)

Bob Hall (R)

House Sponsor

Rep. Janie LopezRepublican · Primary Sponsor

Bill Text(with markup)

S.B. No. 456

View bill text in multiple formats on Texas Legislature website

Fiscal NoteView Original

	AN ACT
	relating to the purchase or sale of human organs; increasing a
	criminal penalty.
	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
	SECTION 1. Section 48.02(d), Penal Code, is amended to read
	as follows:
	(d) An offense under [~~A violation of~~] this section is a
	state jail felony [~~Class A misdemeanor~~].
	SECTION 2. Subchapter B, Chapter 164, Occupations Code, is
	amended by adding Section 164.0571 to read as follows:
	Sec. 164.0571. REQUIRED REVOCATION OF LICENSE FOR PROCEDURE
	INVOLVING CERTAIN HUMAN ORGANS. The board shall revoke the license
	of a physician if the physician knowingly uses a human organ
	obtained in violation of Section 48.02, Penal Code, in a medical
	procedure.
	SECTION 3. Section 48.02(d), Penal Code, as amended by this
	Act, applies only to an offense committed on or after the effective
	date of this Act. An offense committed before the effective date of
	this Act is governed by the law in effect on the date the offense was
	committed, and the former law is continued in effect for that
	purpose. For purposes of this section, an offense was committed
	before the effective date of this Act if any element of the offense
	occurred before that date.
	SECTION 4. Section 164.0571, Occupations Code, as added by
	this Act, applies only to conduct that occurs on or after the
	effective date of this Act. Conduct that occurs before the
	effective date of this Act is governed by the law in effect on the
	date the conduct occurred, and the former law is continued in effect
	for that purpose.
	SECTION 5. This Act takes effect September 1, 2025.

LEGISLATIVE BUDGET BOARD
Austin, Texas

FISCAL NOTE, 89TH LEGISLATIVE REGULAR SESSION


April 21, 2025

TO:	Honorable Pete Flores, Chair, Senate Committee on Criminal Justice

FROM:	Jerry McGinty, Director, Legislative Budget Board

IN RE:	SB456 by Middleton (Relating to the purchase or sale of human organs; increasing a criminal penalty.), As Introduced

No significant fiscal implication to the State is anticipated.

The bill would increase the criminal penalty for the offense of the purchase or sale of human organs from a Class A misdemeanor to a state jail felony. The bill would furthermore require the revocation of a physician's license if the physician knowingly uses a human organ obtained from the offense.

It is assumed that any fiscal impact and any impact on state correctional populations or on the demand for state correctional resources would not be significant.

Local Government Impact

It is assumed that any fiscal impact to units of local government associated with enforcement, prosecution, supervision, or confinement would not be significant.

Source Agencies:

212 Office of Court Administration, Texas Judicial Council, 304 Comptroller of Public Accounts, 503 Texas Medical Board

LBB Staff:

JMc, MGol, AMr, QH

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Frequently Asked Questions

Common questions about SB456

What does Texas SB456 do?

SB456 fundamentally alters the risk profile for transplant medicine in Texas by elevating the illegal purchase or sale of human organs to a State Jail Felony and mandating the revocation of a physician's license for knowingly using such organs. This legislation removes the Texas Medical Board’s discretion in disciplinary proceedings, meaning a single supply chain failure involving "knowing" use results in the permanent loss of a physician's ability to practice. Implementation Timeline Effective Date: September 1, 2025 Compliance Deadline: September 1, 2025.

Who authored SB456?

SB456 was authored by Texas Senator Mayes Middleton during the Regular Session.

When was SB456 signed into law?

SB456 was signed into law by Governor Greg Abbott on June 20, 2025.

Which agencies enforce SB456?

SB456 is enforced by Texas Medical Board, Local District Attorneys and Texas Law Enforcement Agencies.

How urgent is compliance with SB456?

The compliance urgency for SB456 is rated as "critical". Businesses and organizations should review the requirements and timeline to ensure timely compliance.

What is the cost impact of SB456?

The cost impact of SB456 is estimated as "low". This may vary based on industry and implementation requirements.

What topics does SB456 address?

SB456 addresses topics including crimes, crimes--against persons, crimes--against persons--general, criminal procedure and criminal procedure--sentencing & punishment.

Legislative data provided by LegiScanLast updated: November 25, 2025

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