Losing luggage on a commercial flight is an inconvenience, but losing an organ for transplant could cost a life. Alarmingly, scores of organs are discarded each year because they do not reach their destination in time.

Nearly 113,000 people are waiting for organ transplants at any given time. Organs for transplant have a relatively short shelf life — ranging from six hours for hearts and lungs to 30 hours for kidneys — and there are frequently hundreds of miles between the donor and the recipient. To get to their destinations while still viable, organs are often flown on commercial airliners.

Sometimes, flight delays and mishaps can prevent organs from reaching their recipients in time.

In 2018, for example, a human heart intended for transplant went missing during a commercial flight on a Southwest Airlines plane. Transplant officials emphasized that organ reached its destination on time, as the organ was not to save the life of a waiting patient, but for valves and tissues. Many dismissed that high-profile event as an anomaly, but transplant organs are frequently lost or delayed during shipment on commercial flights. In some cases, delays render the organs unusable.

In an investigation by Kaiser Health News and Reveal from the Center for Investigative Reporting, researchers attempted to the scope of the problem. They reviewed data from the United Network for Organ Sharing (UNOS) regarding more than 8,800 organ and tissue shipments between 2014 and 2019.

During those years, almost 170 organs were not viable for transplantation after transportation problems and almost 370 had delays of two or more hours. Another 22 organs initially classified as transportation failures were ultimately transplanted elsewhere.

What Happens to the Organs?

Depending on the organ and the distance it must travel, surgical teams sometimes collect and transport hearts and other organs themselves. Kidneys and pancreases often travel along with luggage as commercial cargo, which puts them at risk for missed connection flights and delays.

To make matters worse, tracking of these organs typically involves a primitive system of paper manifests and phone calls, devoid of GPS or other electronic tracking. These dysfunctional logistics can rob patients of their opportunity to receive a lifesaving organ. It is also a frustrating experience for transplant surgeons.

“We’ve had organs that are left on airplanes, organs that arrive at an airport and then can’t get taken off the aircraft in a timely fashion and spend an extra two or three or four hours waiting for somebody to get them,” said Dr. David Axelrod, a transplant surgeon at the University of Iowa.

A number of factors contribute to the loss of viable organs due to transit issues. Reliance on organ procurement organizations (OPOs), rather than on a national system to transfer organs from one region to distance match is one such factor. OPO teams monitor procurement procedures and ensure proper packaging and labeling for shipment and delivery. From there, OPOs frequently rely on commercial carriers and airlines, which are not formally accountable for any ensuing problems. In other words, an airline faces no consequences if workers forget to put an organ on a plane or a courier misses a flight.

Despite the ability for everyday consumers to monitor their FedEx packages or a DoorDash dinner deliveries, there are currently no requirements to track organ shipments in real time.

“If Amazon can figure out when your paper towels and your dog food is going to arrive within 20 to 30 minutes, it certainly should be reasonable that we ought to track lifesaving organs, which are in chronic shortage,” Axelrod said.

Furthermore, there is currently no requirement to assess how many organs are damaged or lost in transit. “We have been unaware of how many kidneys have been waylaid,” said Ginny McBride, executive director of OurLegacy, an OPO in Orlando, Florida. “That’s not a number that’s been transparent to us.”