Unfortunately, the occurrence was all too common—Joseph Scalea was stuck waiting for a kidney to arrive from a donor so he could transplant it into a waiting patient. An organ delivery that should have only taken a few hours was now going on 29. It wasn’t the first time this had happened, but the frustrated surgeon was determined to make it a thing of the past.
"Way too much time transpires from the time an organ is explanted and the time it’s implanted—there’s got to be a better way to do this," says Scalea, M.D., assistant professor of surgery at the University of Maryland School of Medicine. "What if you had on-demand organ delivery, akin to an Uber or Amazon Prime? Why can’t I just get my organ when I want it?"
His answer to those questions: drones. More than three years and 44 test flights later, Scalea and his team completed the world’s first successful delivery of an organ for transplant via drone.
Addressing the organ shortage, transportation issues
The number of patients awaiting organs greatly outpaces the supply. According to the Health Resources and Services Administration, more than 113,000 Americans are on the organ transplant waiting list—2,000 of whom are children. The available organs are typically transported via a combination of methods depending on the distance involved, including ambulances, helicopters, commercial aircraft and couriers, making the organs susceptible to traffic and scheduling delays.
Each passing minute renders organs less viable for transplantation, so the goal for Scalea was to shorten organ transit times as much as possible.
Working with the University of Maryland’s aerospace department, Scalea retrofitted a small drone and conducted 14 test flights with a research organ to test the effects of the drone flight on the organ’s tissue. Publication of that study led to further funding for a custom-made drone and, ultimately, the successful organ delivery. That test—a flight of less than three miles from the organ bank to the hospital—culminated in the successful transplantation of a donor kidney to a 44-year-old Baltimore woman in April.
Pediatric organ donation
With pediatric organ donation and transplantation comes a variety of challenges. Among them, according to the American Academy of Pediatrics, are availability of and access to donor organs, ethical and social concerns and public awareness of the need for organ donors of all ages.
Layered onto those obstacles are those facing the University of Maryland team hoping to improve the organ transport system by integrating drones. Primary among them, according to Scalea:
- Regulatory approval. Getting the go-ahead from various levels of local and federal government agencies is still a challenge. "We want to be able to fly these organs further than three miles, like we did with the first test flight," Scalea says.
- Proving impact. To obtain public and physician acceptance of drone organ deliveries, Scalea’s team must demonstrate the true impact of time and lives saved.
- Technology. Scalea’s drone is a custom-built prototype and more will be needed for this process to scale. "Those drones need to be built," Scalea says. "Someone needs to build drones that will do this, and we’re working with some companies that think they can do that."
- Logistical. Drones and the "pilots" responsible for flying them will need to be integrated into the current organ transportation system as seamlessly as possible.
Expanding the influence of drone deliveries
Scalea says he’s heard a lot of positive feedback from his successful April drone flight and continues to work with his team toward more widespread use of drones in organ delivery. He acknowledges that drones are probably not the only answer to tightening up the organ transportation system, but they could soon become a crucial cog in the process.
He ultimately envisions drones playing a more prominent role across all aspects of health care. "They can be so important in improving transportation logistics for all high-value payloads—blood, dialyses, medical supplies for hurricane victims, time-sensitive blood tests and bone marrow," Scalea says. "2020 will be an incredibly exciting year."