Organ transport requests a seat upgrade: New FAA and DOT working group will help move organs for transplant from airplane cargo to cabin to save more lives

Giving someone else the gift of life through an organ is one of the most selfless acts a person can do. That gift should be handled with the deference and respect it deserves. To ensure that happens, the Federal Aviation Administration (FAA) and the Department of Transportation (DOT) will convene a working group to develop best practices for transporting organs in the cabin of a commercial airplane. 

The FAA Reauthorization Act of 2024, which President Biden signed into law on May 16, 2024, requires the FAA and DOT to create the working group within 90 days of enactment (meaning the group needs to be created by Aug. 16, 2024). 

More than 90,000 Americans are on the kidney transplant waiting list. In 2023, just over 28,000 — or about 1 or 4 — were able to get a kidney. With so many lives at stake, it is paramount that when a kidney becomes available, the waiting patient receives it. However, over 170 kidneys have been lost in commercial air transportation in a five-year period (latest data is from 2019), and there were about 370 near misses.  A "near miss," is defined as a two-hour delay from the anticipated arrival of the organ. The working group will be formed to help make sure that these losses and near misses do not continue.

These losses are partly attributed to the way organs are transported. Currently, organs for transplant are held in cargo on commercial flights. Due to safety precautions implemented in response to the terrorist attacks of Sept. 11, 2001, airport security protocols were changed, and non-ticketed passengers were no longer permitted to go to the gates. Organs for transplant have traveled through cargo ever since.  Without someone traveling with the organ to place it on the flight, there have been errors. A study of 2012-2013 transported organs showed that 47 kidneys had to be discarded due to shipping issues, including loading the organ on the wrong flight, failing to load the organ or damaging the container.

The working group aims to establish best practices that would allow organs to travel in the cabin of a commercial airplane instead of the cargo. The participants in the working group will include leaders representing the air carriers, organ procurement organizations (OPOs), organ transplant hospitals, flight attendants and other relevant federal agencies involved in organ transportation. They will create a standardized process for the accepting, handling, managing and transporting the organ in the cabin of the airplane. They will also create a protocol to ensure the safe and timely transportation of the organ, including how to address connecting flights through commercial airfare. 

Once these protocols and regulations are finalized, the organ losses are expected to decrease exponentially. Airline staff, including flight attendants and gate crews, will know about the organ on board. They also can help ensure an organ does not get lost.

The American Kidney Fund will keep you updated on the formation of the working group and will keep you apprised of the proposed and final regulations.