A precious payload

Every second counts in this mission. Transplant teams have only a few hours to work with when an organ is taken from a living donor, and each passing minute reduces the organ’s health and viability. Delay has a measurable negative impact on the recipient’s quality of life.

Dr. Joseph Scalea of the University of Maryland Medical Center believes that unmanned aircraft can become key links in a logistics chain that has seen little innovation over the 60-year history of human organ transplantation. A series of research flights in April 2018, including one that covered about three miles with a human kidney in the payload package, all within visual line of sight, demonstrated that a human organ can be transported by drone and arrive at its destination every bit as viable as it started.

The results of this first test of human organ transportation by unmanned aircraft were published this month, and the engineers and pilots of the University of Maryland UAS Test Site are working with Scalea to take the next steps toward making human organ delivery by drone routine.

Matt Scassero, director of the unmanned aircraft test center, said his staff developed a phased testing approach that will build on the initial test flights in the coming year, possibly culminating in the transport of a human organ that will actually be implanted in a recipient. For the first test, the team was provided with a human kidney that was not healthy enough to be given to a recipient; the donor’s family agreed to allow its use in medical research.

The team selected a DJI M600 hexacopter for the organ transport flight test, and developed an electronic remote monitoring system, the Human Organ Monitoring and Quality Assurance Apparatus for Long-Distance Travel, or Homal, which monitored temperature, vibration, and GPS location of the organ during flight. Telemetry data from the Homal, along with preflight and postflight biopsies of the kidney, confirmed that the organ had not suffered damage during its trip through the southern Maryland sky, a round trip flight that began and ended among the hangars of St. Mary’s County Regional Airport.

(This happens to be the same location where, a few weeks later, the test center staff would host an AOPA video production team to film the first AOPA Drone Minute safety videos.)

UAS pilot Ryan Henderson said that cooperative weather, with clear skies and calm winds, helped make the flights relatively routine. The longest of these lasted about 12 minutes and extended just beyond the airport property, relatively simple from an aeronautical standpoint. The team had prepared for the organ’s arrival by test flying the aircraft fitted with an empty insulated cooler and monitoring system, and confirmed that the sensor package that Scalea developed (which transmits data through a cellphone network) would not interfere with the aircraft controls.

“We did our due diligence with understanding not only the payload, but the flight characteristics of the aircraft,” Henderson said in a telephone interview. “It was important that we got it right on the first flight.”

The team had about 48 hours’ notice ahead of the actual kidney’s arrival, an unusually long lead time compared to some organ transportation missions where a living recipient is waiting, but still a rather tight timetable. In the coming months, they hope to be entrusted with a kidney that a surgeon will ultimately implant, the next major step toward Scalea’s vision of making this kind of mission routine.

“We plan to move forward, we plan to learn more about the barriers of entry to organ drone transportation with the goal of improving the quality of life for organ transplant recipients,” Scalea said in a telephone interview. He believes thousands of organs that might otherwise be lost could wind up matched with recipients once this reality is realized, saving thousands of lives and improving the qualify of life for those who receive donated organs by reducing the transport time, and the damage that is done during the interval between the organ’s harvest and implantation.

There are regulatory hurdles to be cleared, both in the air and in the medical community. Future organ transportation flights will almost certainly involve operations in controlled airspace and beyond visual line of sight; current regulations also require that human organs intended for transplantation be accompanied by medical staff at all times.

Scalea said the research is proceeding with care, “making sure we don’t break down any of the trust that exists at present between organ donors and their families and the system of transplantation. We don’t at any point want to implement a technology that detracts from that trust. We don’t want people thinking that we are mishandling their organs.”

Scassero said that the aircraft side of the equation is also being approached with care. Among the challenges ahead is determining which aircraft system is best suited to the mission, and that is as much about reliability as capability. The test center’s Director of Operations Tony Pucciarella has developed an unmanned aircraft maintenance and data logging application that will help with that. AlarisPro, an online fleet management and predictive maintenance service for UAS, has been gathering data on active systems for several years.

Scassero said safety mitigations such as automated ballistic recovery systems (parachutes) will likely be added as the team seeks FAA approval for flight beyond visual line of sight, or over people, likely in a densely populated urban environment.

“In each phase we’ll present a safety case that supports what we want to do,” Scassero said. “Whatever that safety case is, we’ll create that as we go through our crawl, walk, run” process. “At any point, of course, we could hit a brick wall. We just have to take that as it comes.”

Someday, Scassero and Scalea believe, this will be a routine mission.

“The crew at the UAS test site in southern Maryland is the best of the best,” Scalea said. “They are professional, they are knowledgeable, they are helpful and they are interested in moving the needle … I can’t make enough positive remarks about them.”

UMD UAS Test Site Project Manager Jim Alexander said the April 2018 flight left him with a lasting memory: During the final operational readiness review, Alexander recalled, Scalea noted that the mission was made possible by the generous donation that a grieving family had authorized, and that Scalea’s recognition of that generous act, with all the implications it carries for future patients and families, stuck with him.

“That was the one thing I’ll always remember,” Alexander said.