How Lifesaving Organs For Transplant Go Missing In Transit
February 26, 2020 7:29 AM Subscribe
Mod note: A few comments deleted; kicking this people-actually-die topic off with a lighthearted riff on a tv show is confusing for people who don't know that show, and also tacky.
posted by LobsterMitten (staff) at 8:07 AM on February 26, 2020 [6 favorites]
posted by LobsterMitten (staff) at 8:07 AM on February 26, 2020 [6 favorites]
I'm kind of shocked to see that these are travelling on commercial airlines. Surely making a deal with FedEx or DHL would get them places faster and more economically?
posted by Mchelly at 8:18 AM on February 26, 2020
posted by Mchelly at 8:18 AM on February 26, 2020
It seems so obvious that there are better systems. No GPS tracking in organs for transplant? GPS trackers are not that expensive, surely, especially as many places have better pricing for non-profits and I assume this would count.
posted by jeather at 8:23 AM on February 26, 2020 [1 favorite]
posted by jeather at 8:23 AM on February 26, 2020 [1 favorite]
It seems so obvious that there are better systems.
There are vastly better systems available, with every kind of tracking a person can imagine (location, pressure, time, temp, shock, humidity, leaks, etc. etc. etc.), but the organizations involved are actively choosing to not use them. FedEx has a specialized medical products delivery system, for example.
...and many of the same organizations actually do use the superior delivery systems (eg: for medical isotopes), they just choose to avoid using them for organs. Gotta pay the CEO somehow, ya know.
posted by aramaic at 8:35 AM on February 26, 2020 [9 favorites]
There are vastly better systems available, with every kind of tracking a person can imagine (location, pressure, time, temp, shock, humidity, leaks, etc. etc. etc.), but the organizations involved are actively choosing to not use them. FedEx has a specialized medical products delivery system, for example.
...and many of the same organizations actually do use the superior delivery systems (eg: for medical isotopes), they just choose to avoid using them for organs. Gotta pay the CEO somehow, ya know.
posted by aramaic at 8:35 AM on February 26, 2020 [9 favorites]
A smaller city may only have one Fedex or UPS flight per day but several flights to one or more airline hubs.
posted by leaper at 9:21 AM on February 26, 2020 [5 favorites]
posted by leaper at 9:21 AM on February 26, 2020 [5 favorites]
Scores?
Well, you know they are clickbaiting when they have to use "scores." It seems this is less than 1 in 1000. Not good, but not exactly surprising in a complicated system in which you may have to get from hospital room to hospital room across the country in hours.
posted by JackFlash at 1:02 PM on February 26, 2020 [1 favorite]
Well, you know they are clickbaiting when they have to use "scores." It seems this is less than 1 in 1000. Not good, but not exactly surprising in a complicated system in which you may have to get from hospital room to hospital room across the country in hours.
posted by JackFlash at 1:02 PM on February 26, 2020 [1 favorite]
Technically a "score" is 20. The article gives a number of 170 discarded over 5 years, which is 34 per year. Dozens is probably more appropriate there, since it's not quite two score. On the other hand, adding in the near misses makes it 108 per year, for which 'scores' can easily apply.
Whatever the number though, every organ matters. Every one is life to the recipient and the final act of the donor.
When my mother died, she was a donor candidate, and the idea that something good could come from this horrible thing meant something to me. Ultimately her organs were not usable for transplant, which was like a final door closing. It would also have been awful if her organs were taken for transplant but lost because we don't track them properly. We owe it to both the donor families and the recipients to get those organs where they need to be, on time and in good condition. It is our sacred responsibility. If we are losing organs because the system is flawed and complicated, we must change the system.
posted by vibratory manner of working at 2:57 PM on February 26, 2020 [11 favorites]
Whatever the number though, every organ matters. Every one is life to the recipient and the final act of the donor.
When my mother died, she was a donor candidate, and the idea that something good could come from this horrible thing meant something to me. Ultimately her organs were not usable for transplant, which was like a final door closing. It would also have been awful if her organs were taken for transplant but lost because we don't track them properly. We owe it to both the donor families and the recipients to get those organs where they need to be, on time and in good condition. It is our sacred responsibility. If we are losing organs because the system is flawed and complicated, we must change the system.
posted by vibratory manner of working at 2:57 PM on February 26, 2020 [11 favorites]
I wonder if you could combine the jobs of people already on the planes. Could an air marshal also carry organs in discreet boxes? Or would that be too obvious for their purposes? If not them, how about a specially qualified class of flight attendant whose job is to carry the organ from start to finish and to serve snacks and drinks?
posted by pracowity at 2:35 AM on February 27, 2020 [1 favorite]
posted by pracowity at 2:35 AM on February 27, 2020 [1 favorite]
The article says that this system is no Fedex but I'm not sure Fedex would be any better? Estimates of Fedex's on-time overnight delivery rate that I've been able to find range from about 93% to 98%. If you'd want to improve this it seems like the escort system described above would be the way to go.
posted by phoenixy at 3:17 AM on February 27, 2020
posted by phoenixy at 3:17 AM on February 27, 2020
A smaller city may only have one Fedex or UPS flight per day but several flights to one or more airline hubs.
I'd be very surprised if hot-shot couriers wouldn't be able to fill this gap. Sure there's still a risk of ground delays but you'd get the same thing if weather rolled in or if a SNAFU snarled an air hub. They aren't cheap compared to UPS or DHL but I bet they're cheaper than a charter flight and, on reading the article, it seems like the Doctor in one of the examples used the same to get the delayed organ from Atlanta to their office with 45 minutes to spare.
It's insane that this isn't an almost bombproof system given the stakes and the overhead costs for the medical steps along the way.
posted by RolandOfEld at 7:45 AM on February 27, 2020
I'd be very surprised if hot-shot couriers wouldn't be able to fill this gap. Sure there's still a risk of ground delays but you'd get the same thing if weather rolled in or if a SNAFU snarled an air hub. They aren't cheap compared to UPS or DHL but I bet they're cheaper than a charter flight and, on reading the article, it seems like the Doctor in one of the examples used the same to get the delayed organ from Atlanta to their office with 45 minutes to spare.
It's insane that this isn't an almost bombproof system given the stakes and the overhead costs for the medical steps along the way.
posted by RolandOfEld at 7:45 AM on February 27, 2020
I work in an organ transplant laboratory and while this is definitely a problem I would like to see actual data on how many organs are not transplanted due to transportation delay. In my experience, while organs that are delayed may not go to the top of the list intended recipient, they are usually transplanted. For example (this is real), we had a kidney that was meant to be put on a plane to a recipient but the TSA for whatever random reason insisted that the courier open the box. The courier rightfully refused and was turned away. This obviously initiated a huge investigation to prevent this ever happening again, but when it became apparent that it was going to take a while to sort things out the kidney was transplanted to the local recipient nearest the top of the list rather than be discarded. We always run testing on local back up recipients even when it looks like an organ is going to be sent out for just this reason.
It really does seem to work fine the majority of the time. We also send donor blood samples for crossmatch purposes by commercial flights ahead of the organs in some cases. The availability of commercial flights means that it's a cost effective way to transport time sensitive materials. If you don't live near the ocean but enjoy good sushi in your town, there's a good chance it got there on a commercial flight.
posted by Missense Mutation at 4:00 PM on February 27, 2020 [11 favorites]
It really does seem to work fine the majority of the time. We also send donor blood samples for crossmatch purposes by commercial flights ahead of the organs in some cases. The availability of commercial flights means that it's a cost effective way to transport time sensitive materials. If you don't live near the ocean but enjoy good sushi in your town, there's a good chance it got there on a commercial flight.
posted by Missense Mutation at 4:00 PM on February 27, 2020 [11 favorites]
Flagged as fantastic because of course mefi hosts a transplant lab worker intimately familiar with this process. Sheesh, nice.
posted by RolandOfEld at 4:23 PM on February 27, 2020 [2 favorites]
posted by RolandOfEld at 4:23 PM on February 27, 2020 [2 favorites]
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posted by soelo at 8:00 AM on February 26, 2020