Transplant Organs Should Stop Flying Coach

THERE'S A FASCINATING investigative piece over at Kaiser Health News by JoNel Aleccia about organs for transplant getting delayed in transit between donor and recipient, thus rendering them unusable.

It’s hard to tell from the various voices in the article if this is actually a significant problem in the organ procurement system, but I suppose one could make the argument that this should count as a health care “never event": no one should miss out on a life-saving transplant because the kidney was accidentally left in a cargo hold area at ATL.

The most surprising revelation in the article, though, is how human organs are transported around the country. There are 58 independent organ procurement organizations (OPOs) in the U.S., divided by region, each responsible for shuttling kidneys, pancreases, livers and the like from the site of harvest to the hospital where they will be transplanted. Sometimes the organ only has to go a few miles within the same city or state, but those without a local match will travel longer distances by air. Each OPO determines how it will send the organs, and—here’s the bonkers part—many rely on professional courier services and commercial airlines.

I’m sorry, what?? My liver was supposed to arrive on the next Southwest flight from Detroit but it got bumped because it forgot to check in online?

Transporting live human bodies is

very different from transporting

body parts.

I joke, I joke. To be fair, the article does mention that organs get priority boarding, and I’m willing to bet they don’t get charged extra for printing their boarding pass at the airport. The serious question, though, is how this was allowed to become an acceptable industry practice. Here in the U.S. we have companies that are highly experienced in complex logistics, focusing obsessively on getting things from Point A to Point B in the fastest and most efficient way possible. American Airlines is not one of them, and I’m not saying that because they’re a bad company (which they do happen to be), but because transporting live human bodies is very different from transporting body parts. Commercial airline operations are subject to the whims and follies of people, who arrive late, have trouble lining up, and bring miniature horses on board. Loading a cargo plane with packages requires much less herding and coddling, and the boxes don’t complain about legroom.

I assume the reason OPOs have long relied on this arrangement is that it is the least expensive way to get organs to their destinations with a decent degree of reliability—or at least it used to be. To me, it feels a little antiquated. I can get a pint of Ben and Jerry’s at my doorstep in two hours, and I can get a pair of socks from a warehouse in Kentucky delivered in a day. These fulfillment networks have been honed over time to maximize efficiency and eliminate delays, and they’re only getting better.

So why not outsource organ delivery to Amazon, or FedEx? If the goal is to make delays in organ procurement a thing of the past, to never have to cancel another surgery because the organ didn’t make it in time, it only makes sense to use a company with a proven track record of success. I bet Jeff Bezos wouldn’t mind the business, and it would make for good PR. Plus, can you imagine a kidney arriving to the OR by drone?

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