Organ Transplantation Policy Act of 1986 - Amends title XVIII (Medicare) of the Social Security Act to require that before an organ is transplanted, exported for transplantation, or transferred to another hospital or organ procurement agency for transplantation, the hospital or agency determine whether the intended recipient of such organ is a nonresident alien. Provides that before the recipient can be a nonresident alien or the organ can be exported for transplantation: (1) such hospital or agency must contact the appropriate organ transplantation network and cooperate with such network in arranging for transplantation of the organ into a permanent resident or citizen, or at a hospital in the United States; and (2) the appropriate organ transplantation network must determine that there is no suitable recipient who is a permanent resident or citizen, or no suitable recipient at a hospital in the United States.

Requires hospitals and agencies to report to the Secretary of Health and Human Services regarding: (1) the procedure followed for each organ transplant, transfer, or export with which such hospital or agency was involved; (2) the type of organ involved; (3) the status of the intended recipient; and (4) if such recipient was a nonresident alien, the date the appropriate organ transplantation network was contacted. Excepts an individual's donation of his or her organs for use in a specific individual from the requirements of this Act.

Directs the Secretary to review the records of hospitals and agencies having a substantial involvement in providing organ transplants to nonresident aliens or exporting organs for transplantation to determine whether such hospitals and agencies have complied with the requirements of this Act.