Valuable time is often lost during the transport of donor organs. Experiments are being carried out with unmanned drones that bring kidneys, lungs or heart to a hospital. Is this method also necessary for the Netherlands?
Last September, at night in a hospital in Toronto, Canada, a man (63) was waiting hopefully in an operating room, while the chief surgeon on the roof scanned the sky. They waited for a drone with donor lungs on board. It was the world’s first unmanned aerial transport of lungs.
Donor organs are scarce. In the Netherlands alone, there are hundreds of people on the waiting list. If a donor heart, lung or kidney is available, the transplant should take place as soon as possible. The quality decreases as soon as an organ leaves the donor’s body. If that takes too long, the transplant may fail.
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Now donor organs are transported by car, plane or helicopter. In busy cities, such as Toronto, traffic is a major obstacle to road transport. That problem is a thing of the past with the use of unmanned aerial vehicles for organ transport, Canadian researchers write in an analysis of last year’s drone flight in the trade journal Science Robotics.
“The ability to fly directly from the donor to the transplant hospital leads to shorter travel times, more reliable scheduling and less strain on medical staff,” said Andrew Sage of the Toronto General Hospital Research Institute.
In 2019, a drone in the United States also delivered a kidney to a person (44). The time gain of a few minutes was less essential here than with long transport. Heart and lungs must be transplanted within four to six hours of being removed from the donor, while a kidney remains good for 24 hours.
Organ transport box
Extensive, years-long preparation preceded the transport of the lungs in Toronto. The researchers used a commercially available drone that is 1.6 meters wide and 0.7 meters high and converted it. They improved the electronics so they wouldn’t lose control and installed extra cameras, a parachute and a GPS system. They also removed the heavy landing gear and loading rack and mounted a specially designed, lightweight organ transport box.
Although lungs themselves don’t weigh much, heavy equipment is needed to keep the organs cool and healthy. Including life-saving cargo, the drone still weighed no more than 25 kilograms.
After 400 test flights between the roofs of Toronto’s two hospitals – where special landing platforms had been built – the drone was ready for its first organ transport. In September 2021 the time had come. Donor lungs were available and the weather conditions were good: no rain, little wind and good visibility. The airlift over a distance of 1.5 kilometers, which took about five minutes, and the subsequent lung transplant were a success. Good news for the pulmonary fibrosis patient who was allowed to go home two days after the transplant.
“Compared to other organs, lungs are difficult to transport because they are large and require more preservative fluid,” says Sage. ‘So the successful delivery of lungs shows that routine transport of other organs is also possible.’ He thinks this can be done within five to ten years. ‘The biggest challenge is the integration of this technology into existing air traffic.’
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Yet, according to Ruben de Gram, organ donation transport manager at Witte Kruis in the Netherlands, organ transport by drone is still a long way off. First, it must be technically possible to reliably transport organs and the necessary conservation equipment. “It is inconceivable that a drone with an organ crashes due to a technical problem.”
Furthermore, extensive infrastructure is needed, such as landing systems, so that the drones can fly between hospitals and delivery locations. This must be done in the Netherlands as well as in all other countries affiliated with Eurotransplant, the organization responsible for the recruitment and coordination of donor organs.
And finally, there are the laws and regulations for the airspace. ‘Because the technology and laws and regulations of drones are actually still in their infancy, it is not yet possible to work with a drone from the Netherlands to Germany, for example,’ says De Gram.
Drone transport may have advantages in countries, such as Canada, where organs have to be transported over great distances, but De Gram sees no need for organ transport by drone in the Netherlands for the time being. ‘We are not yet so affected by increasing traffic that the transport of organs is compromised. The advantage of road transport is that human control is present and it is possible to switch quickly between different means of transport. In the Netherlands, tests are being carried out with drone transport of medicines and blood between hospitals.’