Every year, hundreds of donated organs get delayed or even misplaced on their way to save a patient’s life in the US, according to a new investigation.
More than 112,000 people are waiting for transplants in the US. Every day, an average of 20 of these people die waiting for an organ.
The shortage of organs is chronic, costly and fatal for patients with no options left.
Campaigns to convince more people to become organ donors and measures to make more organs eligible for transplantation aim to expand the donor pool.
But a new investigation by Kaiser Health News revealed that organs are all-too-often lost or delayed in transit, untracked and untraceable chinks in the system that, in too many cases, render the tissues unusable.
Some organs can survive longer on ice than others, but it’s a race against the clock before cell death begins and the odds of a transplant’s success start to plummet
Clear labels like these are meant to ensure that organs are handled with care, yet reports have emerged of the tissues left on planes
Every year, an estimated 8,000 people die each year waiting for an organ transplant – most often a kidney.
The 30,000 annual tissue donors fill only a fraction of the transplants needed each year.
With more than 145.5 million people in the US are registered to donate organs and tissue, but many of their generous offers are skimmed off by restrictions put into place to ensure the best odds that a transplant is successful.
US officials from the United Network for Organ Sharing (UNOS), Food and Drug Administration (FDA) and individual Organ procurement Organizations (OPOs) set standards required for organs to be eligible for transplant.
A laundry list of health conditions and lifestyle factors prior to death can disqualify organs, including sepsis, HIV, certain immune diseases, dementia, having abused IV drugs, having taken a growth hormone, non-sterile tattoos or piercings, most people who have had hepatitis, being a rape victim or a recent animal bite or scratch.
If an organ is deemed likely acceptable, the clock starts running.
Doctors must find a person on the waiting list – preferably one as close as possible to the donor’s location – who is a match for the newly available organ, harvest it, transport it and transplant it.
When there’s a patient in need nearby in need of an organ that won’t last long outside the body, like a heart, which lasts just four to six hours, the transplant surgeon has to pick up the organ themselves, by the fastest means possible, often a helicopter.
If there’s no one in the immediate region, the process of getting a donor organ to the proper recipient becomes an ad hoc one, according to Kaiser Health News.
Doctors do local hand-offs of donated organs, but the tissues often travel alone and untracked between states, despite the tight timelines before they are non-viable
There is not a federal, national system that oversees and organizes these inter-regional transfers.
UNOS and donor and recipient hospitals must coordinate quickly to transport organs like pancreases and kidneys that won’t begin to degrade quite as quickly, according to Kaiser Health News.
Without a unified national system, there’s no designated national transport system for these organs.
Instead, organs end up on commercial planes in cargo loads.
And they’re just as vulnerable to all the same frustrating hiccups and delays of commercial airlines that any other traveler and their luggage might be.
Kaiser Health News and Reveal (a project by the Center for Investigative Reporting) identified 170 organs that were so lost in transit between 2014 and 2019 that, by the time they reached their intended recipients, they were unusable.
Another 370 organs were delayed two or more hours, and just barely made it to their recipients within the life-or-death window.
Not only are these organs subject to a system riddled with unpredictable, uncontrollable flaws, but between their departure and destination hospitals, the organs are in the wind.
Apps for Amazon, Uber, and GrubHub can tell you exactly where your product car or dinner are in real time, what time you can expect them to arrive, and alert you for delays.
For organs, however, doctors must rely on phone calls and flights’ paper manifestos.
Obvious though the presence of a human organ may seem, one was left on a Southwest Airlines plane in 2018. Organs are effectively handled like any other cargo
An estimated 3,500 donated kidneys are thrown away each year, despite 100,000-some people waiting for the organs each year
There are no advanced tracking devices attached to the coolers in which organs are transported.
Organs instead travel unaccompanied and untracked, meaning they are treated like any other piece of cargo or luggage on commercial airlines.
In 2018, Southwest Airlines discovered that one of its flights had taken off from Seattle on its way to Dallas with a piece of rather precious cargo that someone had forgotten to take off he plane: a human heart.
The flight had to do a 180-degree turn around in the air to get the ‘life critical’ organ back to Seattle.
Doctors ultimately said the heart reached its destination, and was usable, as it was harvested for valves and tissues rather than to be transplanted whole and intact.
But it was a haunting anecdote – and not the only one of its kind.
Last year, a Florida OPO sent a kidney off to North Carolina, but it missed a connection.
After exploring all the options and doing the math, the North Carolina doctors realized that the best way to get the organ to the recipient in time was to either charter a $15,000 plane, landing with 46 minutes to spare before the organ was nonviable, or send a car to courier the kidney across several states, according to Kaiser.
The kidney made car trip and the transplant was reportedly successful, but it was down to the wire.
These sorts of delays could face as many as one in six kidneys, which are shipped, rather than hand-delivered.
Last year, President Trump proposed a new set of rules aimed at improving organ transplantation outcomes.
It asks for success rates to be more closely tracked and for OPOs to be held accountable – but it makes no mention of transport and tracking for them.
Until such measures exist in the US, it’s likely inevitable that organs will be lost – and wasted – along the way, and with them may go patients whose lives depend on transplants.