Flight delays for organs: Here’s why the donation transportation system needs to change
- The less time an organ spends out of the body, the more likely a transplant is to be successful.
- Current regulations can add a lot of extra time to organ transportation.
- Advocates hope targeted rule changes can make the system more efficient.
Anthony Depasquale’s lung transplant almost didn’t happen.
He had been in the hospital this spring with complications from COVID-19 on a ventilator and in a medically-induced coma for months.
Depasquale was matched with a pair of lungs from a donor in Delaware, but he was being cared for at NYU Langone Hospital in New York, and the lungs still had to get there.
“There was a terrible storm, and they could not fly in those conditions,” Terez Depasquale, Anthony’s wife, told USA TODAY. “By the time they would be able to fly, those lungs were no longer viable.”
Under the current system, organs often have to arrive at airports hours before a flight, and when weather delays kick in, the extra time outside the body can mean they are no longer viable for transplant.
Organ transplants are complicated no matter what, but transporting them over long distances adds another layer of complexity. The United Network for Organ Sharing said in an open letter to Department of Transportation secretary Pete Buttigieg that regulations around how and when organs can be shipped make it more likely for the process to break down.
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The network’s letter asks the DOT to reevaluate some of those rules to make the organ transportation process more streamlined.
“Practical, logistical, and regulatory obstacles to the safe and efficient delivery of donor organs should be identified, remedied, and monitored,” the letter said. “We believe you, the FAA, and TSA could provide valuable assistance on how to increase the efficiency of commercial air transportation of organs for transplant.”
Depasquale ultimately had a successful transplant in May.
About three or four weeks after his initial missed connection, a new pair of lungs became available locally, making the process smoother.
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Organ transplants are already time-sensitive procedures, and any extra delays can make the organs unviable for the recipient.
“A transplant hospital might have to turn down the organ because they wouldn’t get it in time,” McBride said. “The organ might not be able to be used in the most desperate of situations,” as initially happened to Depasquale.
How can organ transportation improve?
McBride said organ transportation policy doesn’t necessarily need a complete overhaul, just incremental adjustments to make it more efficient.
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For now, the network is just asking for time to meet with DOT and other administrators to start a conversation about possible solutions.
McBride acknowledged breakdowns in transportation under the current system are rare. The network’s advocacy is focused on finding efficiencies in the system to reduce those numbers even further.
People can still receive donated organs
Angeles Herrera said a direct-donation kidney transplant saved her life in 2007. She had various forms of kidney disease since childhood and ultimately needed a transplant.
Through a friend, she found a potential donor on life support whose family agreed to make the donation if the two were a match. Among other complications, however, Herrera was in San Francisco, and the donor was in the Washington, D.C., area.
“It was extremely, extremely scary,” she said. Even though Herrera and the donor were a near-perfect match, “it’s very unlikely that the kidney’s going to work because it’s been outside the body for more than 24 hours.”
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Cross-country transportation made the whole process more complex, but Herrera said her nurses were well-informed of the kidney’s progress throughout its journey.
Ultimately, her procedure was a success.
“The kidney began to work immediately,” she said. “People say it’s rare for that to happen when an organ’s been asleep for so long.”
For Depasquale, his new lungs have given him a new outlook on life.
“It was the best thing that ever happened,” he said. “I feel like a lot of the times before, I would take stuff like (seeing my kids when I got home) for granted. Now I’m just appreciating it.”