Political abuse
El Patron clones himself so that he can live forever by harvesting the organs of people whom he views as less than human. This is a metaphor for his parasitic, cannibalistic nature, and from this arrogance his policy can be seen as abusive. He leads an oppressive regime, imposing his authority by fear and domination. He is clearly only interested in what is best for himself, and in the end he proves to be a sociopathic murderer.
Resistance and struggle
Eventually, Matt realizes that the Patron doesn't have his best in mind. He realizes the conspiracy against him and struggles to survive and resist the oppressive dominion of the overlord, or Patron. He is slated for execution, but he doesn't see why his life should be worth less than anyone else's. Also, he doesn't see why he should die for the benefit of an evil leader and not for his people. So, he resists the government and decides in the end to try and overthrow the cartel. His struggle is not easy, and the novel explores how the threat of harm leaves him chronically paranoid.
Community
The only respite to Matt is that he is not the only victim of the Patron's regime. He and other kids form a community to help each other survive, to push each other to do the right thing even when the prospects are genuinely scary, and in the end, they are the ones who teach Matt that as a clone, he is only treated with privilege because he is being fattened for the harvest. They help him understand the stakes of the Patron's evil dominion.