Donated Organs, Especially Kidneys, are at Risk Due to Current Transportation Structure

By ASN Staff

An investigation from Kaiser Health News and Reveal from the Center for Investigative Reporting found that “between 2014 and 2019, nearly 170 organs could not be transplanted and almost 370 endured ‘near misses,’ with delays of two hours or more,” due to transportation problems.  Nearly 113,000 people in the United States waiting for transplants, yet many organs, especially kidneys, are needlessly wasted because they do not reach their destination on time due to transportation issues.

“If Amazon can figure out when your paper towels and your dog food is going to arrive within 20 to 30 minutes, it certainly should be reasonable that we ought to track lifesaving organs, which are in chronic shortage,” said Dr. David Axelrod, a transplant surgeon at the University of Iowa who also represents the American Society of Transplantation, in the Kaiser Health News piece.

The root cause of delayed and lost organs is the system responsible for collecting and distributing them. The nation relies on 58 organ procurement organizations (OPOs), government contractors that monitor donor surgeries, collect the donor organs, and box and label them for shipping and delivery. From that point, OPOs typically rely on commercial couriers or airlines. There are no requirements that OPOs or UNOS, which oversees the contractors, track shipments of organs in real time or quantify those that go missing or experience delays in transit, the article notes.

 “Surgeons themselves often go to hospitals to collect and transport hearts, which survive only four to six hours out of the body. But kidneys and pancreases — which have longer shelf lives — often travel commercial, as cargo. As such, they can end up missing connecting flights or delayed like lost luggage. Worse still, they are typically tracked with a primitive system of phone calls and paper manifests, with no GPS or other electronic tracking required,” reported Kaiser Health News and NBC news on February 8.

Based on the data in the article, UNOS is approximately 15 times as likely to lose, damage or mishandle an organ as the airline industry is your luggage.  “Other industries prove that safely shipping precious cargo is imminently doable and there are zero reasons the organ procurement world shouldn’t have a similarly accountable system in 2020,” said Barbara Murphy, BAO, BCh, Chair of Medicine at Mt. Sinai, ASN Councilor and a transplant nephrologist.

“Last year, an average of nine people a day died while waiting for a new kidney,” said Dr. Murphy.  “Fortunately,” she continued, “the administration has issued a Request for Information asking for input on how our existing organ matching and distribution information technology infrastructure can be improved.  This investigation highlights how important it is that we seek out alternatives and that the government move rapidly to implement significant advancements.  I urge not only my colleagues in nephrology, but also our peers in other sectors with expertise in 21st century distribution technologies, to share insights with the administration.”

Comments on the RFI are due April 14, 2020.

For more information, please see the full article by Kaiser Health News.

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An investigation from Kaiser Health News and Reveal from the Center for Investigative Reporting found that “between 2014 and 2019, nearly 170 organs could not be transplanted and almost 370 endured ‘near misses,’ with delays of two hours or more,” due to transportation problems.  Nearly 113,000 people in the United States waiting for transplants, yet many organs, especially kidneys, are needlessly wasted because they do not reach their destination on time due to transportation issues.

“If Amazon can figure out when your paper towels and your dog food is going to arrive within 20 to 30 minutes, it certainly should be reasonable that we ought to track lifesaving organs, which are in chronic shortage,” said Dr. David Axelrod, a transplant surgeon at the University of Iowa who also represents the American Society of Transplantation, in the Kaiser Health News piece.

The root cause of delayed and lost organs is the system responsible for collecting and distributing them. The nation relies on 58 organ procurement organizations (OPOs), government contractors that monitor donor surgeries, collect the donor organs, and box and label them for shipping and delivery. From that point, OPOs typically rely on commercial couriers or airlines. There are no requirements that OPOs or UNOS, which oversees the contractors, track shipments of organs in real time or quantify those that go missing or experience delays in transit, the article notes.

 “Surgeons themselves often go to hospitals to collect and transport hearts, which survive only four to six hours out of the body. But kidneys and pancreases — which have longer shelf lives — often travel commercial, as cargo. As such, they can end up missing connecting flights or delayed like lost luggage. Worse still, they are typically tracked with a primitive system of phone calls and paper manifests, with no GPS or other electronic tracking required,” reported Kaiser Health News and NBC news on February 8.

Based on the data in the article, UNOS is approximately 15 times as likely to lose, damage or mishandle an organ as the airline industry is your luggage.  “Other industries prove that safely shipping precious cargo is imminently doable and there are zero reasons the organ procurement world shouldn’t have a similarly accountable system in 2020,” said Barbara Murphy, BAO, BCh, Chair of Medicine at Mt. Sinai, ASN Councilor and a transplant nephrologist.

“Last year, an average of nine people a day died while waiting for a new kidney,” said Dr. Murphy.  “Fortunately,” she continued, “the administration has issued a Request for Information asking for input on how our existing organ matching and distribution information technology infrastructure can be improved.  This investigation highlights how important it is that we seek out alternatives and that the government move rapidly to implement significant advancements.  I urge not only my colleagues in nephrology, but also our peers in other sectors with expertise in 21st century distribution technologies, to share insights with the administration.”

Comments on the RFI are due April 14, 2020.

For more information, please see the full article by Kaiser Health News.

Date:
Monday, February 10, 2020