Tennessee Donor Services

Organ procurement first responders move a packaged kidney one step closer to its final destination.

Time is critical when it comes to facilitating organ transplants. Unpredictable ambulance diversions, flight cancellations and severe weather can hinder efforts to bring lifesaving organs to patients in need. Kidneys can survive 24 to 36 hours outside the body when appropriately packaged, but hearts and lungs are only viable for four to six hours.

Tennessee Donor Services, a Centers for Medicare and Medicaid Services-designated donor program, must sometimes find creative ways to overcome hurdles, whether it’s by shipping organs on alternative commercial flights, chartering private aircraft or having staff members drive across the country.

“We run into many different [challenges], but the thing we’re fighting … is time,” said Codey Tisdale, a Tennessee Donor Services first responder who moved into the organ recovery industry after working as a surgical technologist.

More than 42,800 organ transplants occurred in the United States last year, according to data from the United Network for Organ Sharing, the nonprofit managing the country’s organ transplant system. Several dozen people—including patients, families, clinicians, recovery teams and couriers—engage in an organ exchange from start to finish.

“Coordinating is really an art,” said Jill Grandas, executive director of Tennessee Donor Services and a registered nurse.

Tennessee Donor Services

Organs are allocated to those most in need, sometimes requiring long-distance air travel.

But snags in the chain can put a transplant procedure in jeopardy. Last fall, Tisdale helped in the recovery of a heart at a Knoxville, Tennessee, hospital. The donation team typically uses ambulances or security vehicles when driving organs, but none were available, meaning staff had to battle the clock to get the organ on an airplane to Boston. Ultimately, a nurse manager’s husband drove the heart to the airport. The transfer went smoothly from there, Tisdale said.

UNOS is pushing for policy changes to make one aspect of the transplant process more seamless. Interim CEO Maureen McBride wants organ transit via commercial air to revert to the pre-Sept. 11, 2001, process, when packaged organs were placed in the cockpit just before departure and quickly retrieved after landing.

Now, they’re stored in the belly of a plane and subject to rules similar to how luggage is handled, which can delay the time-sensitive deliveries, she said.

Winter weather challenges and a pilot shortage motivated McBride to help write a letter to the U.S. Department of Transportation in December requesting a meeting about the issue with agency leaders. Officials from UNOS and the Federal Aviation Administration were scheduled to meet the week of Feb. 13.

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