Organ transplantation is one of the greatest medical achievements of our time. It is an incredibly complex, advanced, and even dangerous procedure, which requires immense coordination and speed from all parties involved. This is why it is also one of the few medical fields where aviation has become crucial.  

Many different types of aircraft – from commercial airlines and helicopters to drones – are involved in the transportation of organs and, without these aircraft, many life-saving transplants simply would not have been possible.  

To mark essential aviation month at AeroTime, here are three accounts that not only highlight the vital role aviation plays in organ transplantation, but illustrate the drama, speed, and danger behind transporting organs in the air. 

Crashing heart  

On November 9, 2020, an AgustaWestland AW109 helicopter belonging to Prime Healthcare Air transportation, had been transporting a heart between Sharp Grossmont Hospital in San Diego and Keck Hospital in Los Angeles.   

In many ways, the journey was a typical scenario as it is common for an organ donor to be found in one city for a recipient located in another. Transporting either person for operation is not always feasible due to their condition.  

Meanwhile, a heart can be viable for a transplant for four to six hours after it is extracted from the body, which gives the doctors enough time to deliver it via a jet, helicopter or even a car depending on the distance.  

In this particular case, a helicopter was the optimal choice since both hospitals were equipped with helipads and the distance between the two locations - 180 kilometers (112 miles) – meant less than an hour of travel.  

However, as the helicopter was landing in Los Angeles, disaster struck. According to the initial report, during the descent the pilot experienced minor issues with the controls and an attempt was made to abandon the approach. However, before he was able to do so, the helicopter spun out of control and suddenly yawed to the right.  

The pilot tried to keep the machine above the helipad and “dumped the collective”, changing the pitch of the rotor blades so that they would no longer provide the lift necessary to keep the out-of-control aircraft in the air.  

The helicopter crashed into the helipad before coming to a stop. Once hospital personnel were able to rush closer, they found that the pilot was only slightly injured, while the two passengers transporting the heart remained unscathed, refusing any medical attention.  

The heart was recovered and promptly delivered to the operating room. Despite being dropped on the way, an event which attracted considerable media attention, the organ did not sustain any damage and the transplant was a success. 

No frills heart valves  

On December 12, 2018, a Southwest Boeing 737 flight from California landed at Seattle-Tacoma International Airport (SEA), before taking off several hours later to perform a flight to Dallas Fort Worth (DFW).  

Unbeknownst to passengers, a human heart was on board the flight. Transporting an organ on a scheduled flight, let alone a low-cost one, is a highly unusual event. However, there are circumstances when that is the optimal option.  

Even the most time-sensitive cargo, such as a human heart, can be transported on long distance flights, such as the one between California and Washington state. Often this involves private jets, both chartered and aircraft owned by companies spiralizing in similar cargo. Several thousand kilometers can be covered in the four-to-six hours window, depending on the time it takes to transport the heart from the hospital to the airport.  

The window expands further with less time-sensitive cargo. A liver can be kept for more than 10 hours before being transplanted, while a kidney can be kept for over a day. This reduces the necessity for the organ to be transported on a dedicated flight and significantly reduces the cost.   

The heart transported onboard the Southwest flight was not intended to be transplanted whole, just the valves were to be used. Heart valves can be transplanted up to two days after the heart is harvested.  

After landing in Seattle, the Southwest aircraft was refueled and prepared for the following flight. However, a document mix-up occurred, and the recipient of the precious cargo was not found. The aircraft took off for Dallas and reached the eastern side of Idaho before the error was discovered.  

According to reports in the local press, the passengers were informed of the blunder, the aircraft turned around and headed back to Seattle.  

After it landed, the team from LifeNet Health, a non-profit that specializes in organ procurement and transportation, were finally able to take the heart and deliver it to its destination, which was not revealed.  

The whole procedure took several hours longer than intended, but the additional time was not enough to mean that the transplant became unviable. Speaking to the Seattle Times, a representative for LifeNet Health said that the heart had been delivered to the hospital and the procedure was successful. The spokesperson also said that it is not uncommon for the non-profit to transport similar cargo on scheduled flights.   

Another step forward for drone revolution  

During the early morning of April 19, 2019, a large quadcopter drone may have been spotted in the skies above Baltimore, US. It was carrying a white box and landed on the roof of the University of Maryland Medical Center.  

The box contained a human kidney. It took several minutes for the drone to fly between two hospitals, a trip that would have been significantly longer and less predictable via any other mode of transportation.  

Cars are commonly used to transport organs for short distances, and while there are numerous companies and services that specialize in this kind of transportation, driving has its downsides, such as human factors and traffic.  

While drone delivery is still in its infancy, there is one field where it has already been established: medicine. Shaving off just several minutes can save lives when it comes to the delivery of drugs. Delivery of organ transplants can be even more time-sensitive.  

According to numerous studies, doctors often feel that the current system of organ transportation is highly inadequate, and drones could provide the missing link, ensuring even speedier organ delivery. Other studies suggest avoiding traffic by flying over it would reduce the time it takes to deliver an organ by up to several hours.  

The April 2019 delivery was a successful test of a method that has since become more widely used.  

In 2021, a set of lungs was transported between two hospitals for the first time, a larger, more delicate and time-sensitive organ than a kidney. At the time of writing, there have been no reported instances of heart transportation via drone, but it is almost certain that this milestone will be achieved sooner rather than later.  

Currently, the companies and services specializing in organ transplantation have a well-developed and coordinated communication and delivery network, with private jets, helicopters and even commercial aircraft playing a significant role. Drones will undoubtedly transform that network, adding one more aviation component to it, and allowing doctors to save more lives in the process.