Live organ transport

[vbhisey]

What are the rules for transporting live organs on a non-commercial flight by pilots holding a private pilot license? Our club in India has three aircraft, a C172S, a DA 40 and a DA 42. We have been corresponding with the DGCA for several months now to allow us to transport organs free of charge. We have offered to bear all the expenses, including fuel, landing charges, navigation, etc. we would like to know the regulations in other countries for comparison.

[Sam Rutherford]

Now that is one of the most unexpected questions I've ever seen here!

I hope you get some answers, in the meantime, what are the rules in India?

[chevvron]

Don't know if it's the same in India, but if you're doing it privately in the UK based on no revenue earning of any sort, the only rules would be laid down by the senders and receivers of the organs who would need to ensure that the organs get to the recipient safely and in the shortest time as some organs have a time limit on their use.
Factors to take into consideration would be things like is the destination going to be open when you arrive and is it an airport which accepts your type of aircraft; does the pilot have the necessary qualification to make an instrument approach if necessary.
A company at Fairoaks does this type of operation commercially and uses a Kingair, often operating between midnight and 6am, but there are other companies in the UK which use single engined aircraft.

[Katamarino]

Factors to take into consideration would be things like is the destination going to be open when you arrive...

Wouldn't that be a joke. "You can't receive your new heart because some bureaucrat has declared that this 1km strip of tarmac magically becomes forbidden to land on after 6pm".

[ChickenHouse]

I assume by 'living organs' you mean human spare parts? To make it short, the way you desribe - private aircraft and PPL pilots - will be NoGo in most countries. For legal permit to plant used human organs in other bodies you have to fulfil quite a lot of bureaucratic checks, i.e. document cool chain, have a license allowing for transporting potential dangerous goods etceteras. As a private pilot running a private aircraft you would have almost no chance to bring all necessary papers, so a doctor can legally implant the organ in most parts of the world.

I remember reading a story lately of someone trying to transport living sheep in Europe - a MontyPythonian story of 2018. Try to find that and imagine what this makes of your idea of human parts.

[Radgirl]

Not sure which countries you are referring to ChickenHouse, but not true in the Western World.

A lot of human tissue is transported on commercial flights with a volunteer courier. The Charity or organisation overseeing it provides a simple letter but no real permits or licenses.

Kidneys have a shorter sell by date and are usually coordinated via National Transplantation Systems that liase with each other to ensure the best recipient tissue typing. They then use a number of turboprops and jets which may be little more than a one aircraft operation, although not infrequently they charter in the aircraft. They dont use private pilots simply because they need reliability

Hearts and lungs need to be moved quickly and a surgical team normally goes from the recipient hospital to harvest the organs. They charter an aircraft for longer distances, and use road vehicles for shorter distances. The aircraft are again from a private organisation that is known to be able to deliver and big enough to move a team of perhaps four.

So if a small aircraft is needed it will be for an organ where the overall health cost of the transplant procedure means the aircraft cost is relatively insignificant. Although there is nothing stopping the use of some PPL in a 152, I cant really see the advantage. Certainly a surgical team wont agree to that sort of arrangement!

[3wheels]

I thought in the UK this is regarded as a Commercial operation.

The pressures on the pilot can be quite high not only due to medical time constraints but also weather, night, controlled airspace, night operating hours etc.,

I vaguely recall private flights were once allowed but have long since been stopped.

[BigEndBob]

I remember landing at Brum at three in the morning (i was clocking up night hours), it was minus ten degrees (later report said it dropped to -13) and the aircraft that pulled up alongside was an Aztec. Pilot said he had a human heart aboard destined for Edinburgh.

[Sam Rutherford]

Well, assuming he was solo, hopefully there were two human hearts aboard, destined for Edinburgh...

I'll get my coat! :)

[ETOPS]

This report from 1979 came to mind - it was an organ transport flight....

https://assets.publishing.service.gov.uk/media/5422fed7ed915d13710009d7/7-1980_G-BFKO.pdf

[cessnapete]

Did a couple of transplant flights in a King Air out of Chevvrons base some years ago. Single crew, and usually late night early morning due Op Theatre availability at the destination hospital. Surprised at the lack of technology involved, a plastic bag in a Cool Box!
Remember the clearance out of Glasgow, “climb FL270 direct BOV” Pre GPS so eyeballed it!
Usually ended up at LHR as no lights then at home base.
Happy days, very junior LH copilot, permanent Reserve Lines, paid by the Airline, lots of time off to fly real aeroplanes!
Very satisfying missions.

[Radgirl]

a plastic bag in a Cool Box

Still is. Reminds me of a transplant surgeon many years ago who used to get his wife to pick up a kidney at the butchers on Saturdays with the Sunday roast. Kept it in his car in a UK transplant box so when stopped for speeding or other infringements he could wave the box at the policeman and shout 'emergency...transplant'. He told me it always worked as no policeman could tell the difference between a human and a pig's kidney. Wonder they didn't ask why no ice......

[Sam Rutherford]

I can see that working... Bit of a breach of trust though. If caught, he might lose his job as well as getting fined?

[abgd]

It's a really interesting question. Obviously legal aspects will vary by location. In the UK we have volunteer motorcyclists who transport blood products - not sure if they're allowed to break the speed limit as a reward and I don't know any of the details about who owns the bikes and associated equipment - I suspect they're not privately owned as they have specific markings.

My question would be about the practicalities rather than the legalities. I have not got the reference any more, but I have seen a career fatality rate 1/8 for US medical pilots (I think this included both helimed - which didn't surprise me - and medical transfer - which did). It can be hard enough to say 'no' to flying in bad weather as a commercial pilot to start off with. When doing so is likely to lead to the death of a patient it becomes very hard indeed and I have read a number of accident reports where pilots weighed a fairly high risk of killing themselves against the near certainty of killing a patient, and lost.

Next comes the 'time to spare, go by air' issue that flying is often not particularly quick. If you have a slick system for getting the pilot and aircraft ready whilst the donor organ is being removed, and also for transporting the organ from the destination airport to the destination hospital, I can see that this might not be insurmountable. However in the UK one is often limited by the weather. Perhaps this is less of an issue in your region of India, but I suspect that one might get a much better dispatch rate by using professional pilots and more capable aircraft. The problem being that such services become more dangerous and less economically viable if the 'easy' trips are taken from them by amateurs. I realise that India is a developing nation, but from what I've heard from my colleagues medical wages and costs are going up to the extent that doctors are returning to India from the UK because they can make more money there. In such a climate, I feel it should be expected that pilots and medical transfer services should be paid a fair sum for their efforts.

Fast forward 15 years and I think organ transfers will be accomplished by unmanned drones.

You've probably gathered that I don't immediately like the idea, but obviously you know the logistics of what you're proposing better than I do. Still, food for thought.

[double_barrel]

Fast forward 15 years and I think organ transfers will be accomplished by unmanned drones.



Blood is already being routinely delivered by drone in several African countries. These are fixed-wing drones with a range of nearly 200Km and a payload of 5Kg. So I a sure you are right.

[Igundwane]

Fast forward 15 years and I think organ transfers will be accomplished by unmanned drones.

Please don't give Amazon any more ideas.. " Hey Gran, your orders arrived 🤣😂"

[Dusty_B]

In the UK, the NHS requires muti-engine aircraft (fixed or rotary) for organ transfers. Being a live organ, the requirements are effectively the same as if you are carrying human passengers rather than cargo...!

[abgd]

Blood is already being routinely delivered by drone in several African countries

The big difference here is that blood is replaceable - apart from a few rare blood groups you just take another armful. Organs are much scarcer. Eventually I'm sure drones will become reliable enough for the purpose though.

[ChickenHouse]

Blood is already being routinely delivered by drone in several African countries. These are fixed-wing drones with a range of nearly 200Km and a payload of 5Kg. So I a sure you are right.
Fully automated drones with impact injection? Fancy idea!
In the UK, the NHS requires muti-engine aircraft (fixed or rotary) for organ transfers. Being a live organ, the requirements are effectively the same as if you are carrying human passengers rather than cargo...!AFAIK, If it would be the same as carrying passengers, it can be done by Single Engine Turbine since SERA & EASA changed that. The requirement for multi-engine is outdated for quite a while to my records.

[double_barrel]

The big difference here is that blood is replaceable - apart from a few rare blood groups you just take another armful. Organs are much scarcer. Eventually I'm sure drones will become reliable enough for the purpose though.

True. Although in these circumstances prompt delivery by drone makes the difference between life and death. But they are so far 'perfectly' reliable. After many 1,000s of deliveries, last time I asked, not a single vehicle had been lost or delivery failed.


Fully automated drones with impact injection? Fancy idea!


Hoho. Maybe not as crazy as you might think. The payload is dropped by parachute and routinely hits within a couple of meters of the target. So we are kind of moving in that direction - already working on dropping vaccines in pre-loaded syringes! Maybe not a huge step to make them MIRVs!

[BFM]

Still is. Reminds me of a transplant surgeon many years ago who used to get his wife to pick up a kidney at the butchers on Saturdays with the Sunday roast. Kept it in his car in a UK transplant box so when stopped for speeding or other infringements he could wave the box at the policeman and shout 'emergency...transplant'. He told me it always worked as no policeman could tell the difference between a human and a pig's kidney. Wonder they didn't ask why no ice......

Yes, I knew him well. Lovely man. And the story is absolutely true.

[Sir Niall Dementia]

We get called for them from time to time here, there can be a whole lot of waiting around and fatigue issues, and when you commit to go that commitment is that you will get in, so weather minima are pretty important. Longest one I did was a trip from Plymouth to Oxford. Arrived Plymouth at 20:00 and left the next morning at 10:00. Sometimes it can take quite a while to get all the teams together.

The one that really sticks in my mind was a helicopter transfer from Manchester to a hospital near London, I was at the Manchester site waiting when Lady Dementia rang and told me her brother, who had been on the waiting list for a kidney for years had been called in to receive a new kidney, I delivered two to that hospital that night one of which went to him. Its' still going 16 years later, he has brought up his family, lived a full and active life and raised a huge amount of money for research. Every day a lot of thanks are given for the genorosity of the donor's family, their courage at such a time and the team who had to make that first, dreadful approach.

Whenever I'm on a transplant task my mind and heart go to the donor family, their awful loss can mean so much good can be done for so many others, I just don't know how you see past the immediate misery to the good that will be done.

SND

[abgd]

I wonder what proportion of people who choose not to donate their relatives' organs later come to regret it? Not something I had ever considered before.

[Radgirl]

There has been research on this, in the dim mists of time. The answer is very few. It is very complex....

But back to OP. There are no rules or regulations for organs, blood or transplant teams. The words dont appear in the ANO AFAIK. As UK Transplant became richer it decided it wanted more engines / bells / whistles and as the customer they could make any demand they wanted. not an aviation decision.

[Maoraigh1]

But the OP is in India.

[vbhisey]

Now that is one of the most unexpected questions I've ever seen here!

I hope you get some answers, in the meantime, what are the rules in India?
None so far The bureaucrats are twisting themselves in knots trying to find a solution!

Don't know if it's the same in India, but if you're doing it privately in the UK based on no revenue earning of any sort, the only rules would be laid down by the senders and receivers of the organs who would need to ensure that the organs get to the recipient safely and in the shortest time as some organs have a time limit on their use.
Factors to take into consideration would be things like is the destination going to be open when you arrive and is it an airport which accepts your type of aircraft; does the pilot have the necessary qualification to make an instrument approach if necessary.
A company at Fairoaks does this type of operation commercially and uses a Kingair, often operating between midnight and 6am, but there are other companies in the UK which use single engined aircraft.
A representative of the NOTTO (National Organ and Tissue Transplant Organisation) will accompany every organ.
The other factors have been taken into consideration ( airport being open, pilot rated, etc)

[vbhisey]

It's a really interesting question. Obviously legal aspects will vary by location. In the UK we have volunteer motorcyclists who transport blood products - not sure if they're allowed to break the speed limit as a reward and I don't know any of the details about who owns the bikes and associated equipment - I suspect they're not privately owned as they have specific markings.

My question would be about the practicalities rather than the legalities. I have not got the reference any more, but I have seen a career fatality rate 1/8 for US medical pilots (I think this included both helimed - which didn't surprise me - and medical transfer - which did). It can be hard enough to say 'no' to flying in bad weather as a commercial pilot to start off with. When doing so is likely to lead to the death of a patient it becomes very hard indeed and I have read a number of accident reports where pilots weighed a fairly high risk of killing themselves against the near certainty of killing a patient, and lost.

Next comes the 'time to spare, go by air' issue that flying is often not particularly quick. If you have a slick system for getting the pilot and aircraft ready whilst the donor organ is being removed, and also for transporting the organ from the destination airport to the destination hospital, I can see that this might not be insurmountable. However in the UK one is often limited by the weather. Perhaps this is less of an issue in your region of India, but I suspect that one might get a much better dispatch rate by using professional pilots and more capable aircraft. The problem being that such services become more dangerous and less economically viable if the 'easy' trips are taken from them by amateurs. I realise that India is a developing nation, but from what I've heard from my colleagues medical wages and costs are going up to the extent that doctors are returning to India from the UK because they can make more money there. In such a climate, I feel it should be expected that pilots and medical transfer services should be paid a fair sum for their efforts.

Fast forward 15 years and I think organ transfers will be accomplished by unmanned drones.

You've probably gathered that I don't immediately like the idea, but obviously you know the logistics of what you're proposing better than I do. Still, food for thought.
In India, the costs of getting a chartered aircraft to transport the organ are pretty high. A lot of patients cannot afford it, and it's a pity to see eligible recipients suffer because they cannot afford the cost of transport. There were also several instances when the organ had to be discarded because a suitable aircraft was not available. It was after a few of these occasions when we got together and decided to do something about it. We are a sort of a last resort when alternative arrangements cannot be made. For obvious reasons we will not take a risk in adverse weather or if road transport is a viable option.

[Tay Cough]

Shortly after I got my PPL, the company who I trained with (UK) were tasked with flying an organ to Scotland from the Midlands and took the 172 I had been flying the day before.

One of the conrods appeared through the side of the cowling on long finals and the aircraft ditched into the Firth of Forth. Both chaps on board escaped ok and Navy divers recovered the organ a couple of hours later. The operation went ahead successfully with a slight delay.

This may help to explain some reticence in the U.K. towards using singles.

On a couple of occasions since, I have carried organs on the flight deck of the big stuff.

[Radgirl]

Unless the organs were corneas, there is no way they would have used them after being underwater, even if the temperature hadnt changed. The containers are not watertight. Slight risk of infection......But makes a good story :ok:

[simmple]

But makes a good story https://www.pprune.org/private-flying/images/smilies/thumbs.gif

and a true one
seem to remember it was a liver

[abgd]

Like RadGirl I was a bit sceptical - more from the time perspective than the risk of infection - but google came up trumps:

Transplant organ rescued from ditched aircraft. (https://www.google.co.uk/amp/s/www.independent.co.uk/news/uk/transplant-liver-saved-1453304.html%3famp)

To the OP, despite my concerns I wish you luck.

[Radgirl]

I am truly amazed. Mind you it was 1993......and I suppose the surgeon made the decision so he just spoke to God and got the OK

Seriously though, best wishes to OP. Dont try this though :eek:

[vulcanite]

During my career with Flybe in the UK carried quite a few organs for transplant from A to B. Yes they were packed in a cool box, most often carried on the flight deck as cabin crew sometimes not so keen to have coolbox in their galley!!. Brought to the aircraft before departure by the police and collected from the aircraft by the police waiting at t'other end, and ready with the blue lights.. Perhaps surprisingly, but pleasingly so, it always worked like clockwork. Nice to be able to help albeit in a small way.