In a first of its kind event, an unmanned aircraft successfully delivered a human kidney to an operating room where it was transplanted to save a person’s life. An organ transplant requires rapid transportation between the donor and the recipient. The faster the journey, the higher the chance of success.
The flight took place on April 19, 2019 and was a collaboration between transplant physicians and researchers at the University of Maryland School of Medicine in Baltimore; aviation and engineering experts at the University of Maryland; the University of Maryland Medical Center; and collaborators at the Living Legacy Foundation of Maryland.
“This major advance in human medicine and transplantation exemplifies two key components of our mission: innovation and collaboration,” says E. Albert Reece, MD and executive vice president for medical affairs, UM Baltimore. “Innovation is at the heart of our focus on accelerating the pace and scope of discovery, where research can rapidly transform medicine. At the same time, collaboration is the key to our success in providing discovery-based medicine — both in conducting research and in delivering the highest quality patient care.”
The use of an unmanned aircraft opens up many possibilities for improved healthcare outcomes. “As a result of the outstanding collaboration among surgeons, engineers, the Federal Aviation Administration, organ procurement specialists, pilots, nurses, and, ultimately, the patient, we were able to make a pioneering breakthrough in transplantation,” said Joseph Scalea, MD, assistant professor of surgery at UMSOM. He was a leader of the project and one of the surgeons who performed the transplant.
The many technological firsts of this effort include a specially designed apparatus for maintaining and monitoring a viable human organ; a custom built unmanned aircraft with eight rotors and built in powertrain redundancy; the use of a wireless mesh network to control the aircraft and monitor its status; and aircraft operating systems that combined best practices from both unmanned aircraft and organ transport standards.
“We had to create a new system that was still within the regulatory structure of the FAA, but also capable of carrying the additional weight of the organ, cameras, and organ tracking, communications, and safety systems over an urban, densely populated area — for a longer distance and with more endurance,” said Matthew Scassero, a professor at the A. James Clark School of Engineering. “There’s a tremendous amount of pressure knowing there’s a person waiting for that organ, but it’s also a special privilege to be a part of this critical mission.”
Prior to this groundbreaking flight, the Maryland partners worked together to develop and test the unmanned aircraft by first successfully transporting saline, blood tubes, and other materials, and then by transporting a healthy, but nonviable, human kidney. The experiments that led up to this week’s successful flight began in 2016.
According to the United Network for Organ Sharing, which manages the organ transplant system in the United States, there were nearly 114,000 people on a waiting lisst for an organ transplant in 2018. About 1.5% of organ shipments did not make it to the intended destination and nearly 4% had an unanticipated delay of two or more hours.
“There remains a woeful disparity between the number of recipients on the organ transplant waiting list and the total number of transplantable organs. This new technology has the potential to help widen the donor organ pool and access to transplantation,” said Scalea. “Delivering an organ from a donor to a patient is a sacred duty with many moving parts. It is critical that we find ways of doing this better.”
The unmanned aircraft and operating systems were designed by University of Maryland engineers to meet the rigid medical, technical, and regulatory demands of carrying a donor organ for human transplantation. “We built in a lot of redundancies, because we want to do everything possible to protect the payload,” said Anthony Pucciarella, director of operations at university’s unmanned aircraft test site. The safeguards included backup propellers and motors, dual batteries, a backup power distribution board, and a parachute recovery system in case the entire aircraft failed during flight.
The lessons learned from this procedure will help improve unmanned flight protocols in many other areas. The fact that these aircraft are battery powered and therefore have no carbon emissions is a significant plus.