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UNOS CEO Maureen McBride talks on May 1, 2024 about the federal contracting process.
The federal government and a Richmond nonprofit are working to fix how organ transplants fly on commercial airplanes.
The United Network for Organ Sharing, or UNOS, championed a bill that President Joe Biden signed into law this month.
It's designed to improve the problem of recovered kidneys not arriving in the needed time and condition to be transplanted. Roughly 1 in 4 kidneys taken from a dying person never makes it to a needy one.
"This community owes it to patients and donor families to ensure that organs travel as safely and efficiently as possible," said Maureen McBride, CEO of UNOS.
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Before Sept. 11, 2001, transplanted kidneys were shipped on commercial planes under the supervision of the air crew. For other organs, such as hearts or lungs, the transplant surgeon might travel to obtain the organ and bring it back to the hospital.
But kidneys and pancreases are often shipped on commercial planes by couriers. Research indicates the longer an organ is outside the body, the less life it can provide for a new patient.
Following the terrorist attacks, the federal government changed air travel policies, and an organ courier without a plane ticket can no longer go through security. Organs were moved to the cargo holds of planes and are subject to cargo business hours, which vary between airlines and are impacted by staffing shortages, UNOS said.
One transplant surgeon told Congress that she went searching for a kidney that never arrived and discovered it had sat overnight in an airport hangar. An investigation by KFF Health News determine that couriers are 15 times more likely to lose, damage or mishandle an organ in transit than an airline is to lose luggage.
"Organs arriving when a cargo office is closed sit on ice for prolonged periods, increasing the potential for an organ not to be used," UNOS said in a statement.
The new law, the Securing Growth and Robust Leadership in American Aviation Act, sponsored by Rep. Sam Graves, R-Mo., mostly pertains to the workforce development of aviation employees, and it prohibits the Federal Aviation Administration from requiring mask wearing or COVID-19 vaccinations.
It also requires the Secretary of Transportation to convene a working group to develop best practices for transporting organs in the cabins of airplanes. The group, which will include organ procurement organizations that recover organs, transplant hospitals and air carriers, will submit a report with recommendations within one year.
UNOS has worked with donation and transplant groups and the federal government since 2022 to make these changes.
"The bill's passage highlights the bipartisan consensus and understanding of the lifesaving importance of this issue," said McBride of UNOS.
For a while, moving organs in cargo holds was manageable, said Anne Paschke, a spokesperson for UNOS. But the number of organs transplanted has doubled since 2001. Because the system now prioritizes the neediest patients on the waitlist, regardless of where they live, kidneys are moving farther across the country than before. Since the pandemic, staffing shortages at airlines have hampered cargo shipping.
"There was just a perfect storm of increased volume, further distances and decreased access to flights that led to a very real constricting of options and really brought to light the increasing challenges," Paschke said.
It's unclear what kind of effect the move could have on the high number of lost kidneys. Different organ procurement organizations manage transportation differently and do so without a system of best practices, according to Organize, a group dedicated to organ transplant reform.
Cargo holds aren't the only issue plaguing the transportation of organs. When they are transported on planes, they aren't required to have physical trackers, and there is no centralized organ tracking system. UNOS said it is calling for the implementation of both.
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Significant changes are coming to organ transplantation. For the first time since 1986, UNOS will no longer be the sole contractor to oversee organ transplantation.
Earlier this month, the Health Resources and Services Administration issued two requests for proposals to transform the transplant network, conduct its operations, oversee its data and organ matching and to lead communications. The federal agency has indicated it will hire at least two separate contractors.
McBride said UNOS welcomes a competitive bidding process and that UNOS should continue to play a role in the system.
In April, UNOS renewed its contract with a nine-month deal. The federal health department can extend the contract for two additional six-month periods.
Recognize this? 1950s photos from The Times-Dispatch archives
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Eric Kolenich(804) 649-6109
ekolenich@timesdispatch.com
News summary
The background: After Sept. 11, organ couriers without plane tickets couldn't go through security. Organs for transplant were moved to the cargo holds of planes.
What's new: Richmond-based UNOS championed a bill that President Joe Biden signed, designed to improve the problem of recovered kidneys not arriving in time.
What's next: The Secretary of Transportation will convene a group to determine best practices for transporting organs in airplane cabins.
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Eric Kolenich
Growth and Development Reporter
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