Life-Saving Logistics: Moving Live Organs Between Donors And Recipients

It is a familiar scene in every medical drama – doctors in crisp white coats run around in a mad dash to get a live human organ to another hospital as a clock ticks audibly in the background. The process usually involves ambulances, helicopters and lots of flashing lights for effect.

For some people, the race to transport organs from one hospital to another in time to save a life is not just part of their nightly television roundup. It is what they do when they go to work everyday.

Airspace Technologies is one of a handful of logistics companies that have taken up this high- pressure task. The tech-enabled freight forwarder specializes in moving shipments quickly, and sometimes those shipments are live human organs.

"There is a difference between something that is time-critical and life-or-death situations," Airspace Technologies Chief Marketing Officer Bill Hale said. "We deal in the life-or-death situations."

The logistics industry is known for placing a premium on timeliness. Being on time is important because there is money on the line, and stores need inventory to stock. Hours of service regulations, coupled with delays at pick-up and drop-off facilities, often exacerbate this prevalent, sometimes frantic "hurry up and wait" approach to moving everything from pharmaceuticals to ramen noodles. 

When it comes to moving organs, it is more "hurry up" and less "wait." The process of moving hearts, lungs and other organs for transplant is overseen by the United Network of Organ Sharing (UNOS) and regulated by federal Organ Procurement and Transplant Network (OPTN) policies. Packaging, labeling and shipping are all bound by a specific set of rules. Every technicality is accounted for. 

This high level of specificity helps ensure waiting patients get safe, viable organs. It also means all members of the supply chain, from doctors to transport companies, must show up on time, plan for external delays and be aware of every detail that could compromise the shipment. 

"Organ transplants are most successful when preservation and transport time are short," according to the UNOS website. "Donated organs require special methods of preservation to keep them viable between the time of procurement and transplantation."

The maximum preservation time varies by organ, but hearts and lungs max out at about four to six hours, according to UNOS. Other organs last slightly longer, A liver can be preserved for eight to 12 hours, a pancreas can last 12 to 18 hours and kidneys can be viable for as long as 24 to 36 hours. 

Once organs start approaching the far end of these zones, transplant outcomes can suffer, according to the organization.

The clock starts as soon as the organ leaves the donor's body and does not stop until it is placed safely inside the recipient. That means a significant portion of an organ's maximum preservation time needs to be allotted to surgical teams, leaving less time for transport.

"I cannot imagine knowing that you have a family member in a life-or-death situation, needing a transplant, and for whatever reason, the transportation provider cannot get it there in time. That happens," Hale said. "We play in a part of the industry where failure is not an option. It is totally different than moving a truckload of green beans."  

Beating the clock becomes more important than ever when there are human lives on the line, and real-time visibility also goes from being a routine offering to life-saving necessity. Doctors need to know where the organ is located in order to prepare for the procedure and deal with any potential delays. Often, it can be difficult and time-consuming to nail down the location of the shipment throughout the process.

"Being able to provide information is not just for tracking ability. It is really for productivity all the way around," Hale said. "They could probably figure out where that organ is with a couple of telephone calls to their provider, but if they had that information in the palm of their hand, they could look and know exactly where it is and when it is going to be delivered." 

Increased visibility can be particularly important in the event that something does go wrong. Often airlines, freight forwarders and nonprofit organizations are required to work together in order to move an organ. If wires get crossed, mistakes can happen during even the most well-planed transports. Just last year, a human heart was left on a Southwest airplane.

When the donor and the recipient are located within about two hours from each other, organs are moved via ground transportation. When the closest suitable recipient is located farther from the donor, however, organs need to be moved by air. The companies equipped to do these kinds of moves are an essential part of achieving a successful transplant, and they are the reason thousands of viable organs do not go to waste each year due to simple geography.

Surgeons save lives, but it is often the transportation and logistics companies working behind the scenes that make their jobs possible.

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