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For more than four years, Chad Carswell, 38, has suffered from severe kidney disease. In July 2020, he started on dialysis — but now his kidneys are functioning at just 4 percent.

In an interview with The Washington Post, Carswell said he recently applied for a kidney transplant but was turned down because he has not received a coronavirus vaccine. And, despite his hospital's requirements that organ recipients be vaccinated against the virus, he's refusing the shots.

Carswell, of Hickory, N.C., acknowledged his condition is a "ticking time bomb," and said he's living every day as though it's his last. Still, he will not take a coronavirus vaccine — even if that means losing out on a potentially lifesaving transplant.

"There is not a situation in this world that I'll get a vaccine," he told The Post. "If I'm laying on my deathbed, and they tell me, 'You have a kidney waiting on you if you get this shot,' I'll tell them, 'I'll see you on the other side.'"

Carswell is not the only unvaccinated person on a transplant wait list to be denied an organ. Last week, the family of D.J. Ferguson said a Massachusetts hospital denied him a heart transplant because he refused to take a coronavirus vaccine, the Associated Press reported. In October, a Colorado hospital said it would deny a kidney transplant to a woman unless she got vaccinated against the coronavirus.

In both cases, the hospitals cited policies that require all transplant recipients to get vaccinated because of research that shows such patients are at a higher risk of dying from COVID-19. Studies estimate the mortality rate of transplant patients who contract COVID-19 at about 20 to 30 percent, The Post reported.

Boston's Brigham and Women's Hospital, which recently drew criticism for denying Ferguson's heart transplant over his vaccination status, said in a statement that there are more than 100,000 patients waiting for organs, and about half do not receive one in five years.

"Given the shortage of available organs, we do everything we can to ensure that a patient who receives a transplanted organ has the greatest chance of survival," the hospital said. It also cited guidance from the American Society of Transplant Surgeons and other organizations that recommend patients receive coronavirus vaccines before undergoing transplants.

Atrium Health Wake Forest Baptist, the hospital where Carswell was hoping to receive his transplant, declined to comment on his case. In a statement to The Post, a spokeswoman said the hospital's vaccine policy is meant to protect transplant patients, who are at high risk for severe illness from COVID-19.

"[Our] policy follows the current standard of care in the United States, which is to vaccinate all patients on waiting lists or being evaluated for transplant," the statement read, which added: "We understand that some patients may not wish to be vaccinated. In this case, patients can opt to be evaluated at another transplant center."

Carswell told The Post that he has had long history of health problems. After he was diagnosed with Type II diabetes, Carswell said he developed infections and other complications in his legs, both of which had to be amputated. He's had COVID twice, he said — once in November 2020 and again this past September, which landed him in the hospital for a short time.

For the last four and a half years, Carswell said, he's battled stage-four kidney disease, and he went on dialysis in 2020 when his kidney function started to rapidly decline. For the last several months, Carswell said, he's been looking for a new kidney and found numerous people willing to give him one.

It wasn't until an appointment about three weeks ago, he said, that a doctor told him he needed a coronavirus vaccine to be eligible for a transplant. The doctor also told him his kidney donor would need to be vaccinated as well.

That was a problem for Carswell, who said he does not want to be forced to get the shot. He added that he doesn't believe in conspiracy theories about the vaccines, but remains skeptical about how they were developed.

Coronavirus vaccines have passed rigorous safety reviews and are effective in preventing serious illness and deaths. The Centers for Disease Control and Prevention recommends anyone over the age of 5 take a coronavirus vaccine.

But for Carswell, getting a shot comes down to personal choice, he said

"It's about standing up for our rights and understanding that we have a choice," he said.

Carswell said he knows that by refusing to get vaccinated, the donor kidney he so desperately needs will remain out of reach. But he said he is willing to accept the consequences, even it costs him his life.

"I was born free," Carswell added. "I'll die free."