Today, the U.S. House of Representatives approved its 2023 Federal Aviation Administration (FAA) reauthorization bill, which includes a provision aimed at improving safety and efficiency in the transportation of donor organs through the nation's commercial aviation system.
Section 834 of H.R. 3934, the Securing Growth and Robust Leadership in American Aviation Act, requires the Secretary of the Department of Transportation (DOT), in consultation with the FAA Administrator, to convene a working group to develop best practices for the transportation of an organ in the cabin of an aircraft.
Before the September 11 attacks, organs primarily kidneys were transported within a commercial flights cabin, under supervision of the aircrew. Packaged organs were placed in or near the cockpit just before departure and quickly retrieved after landing. The attacks prompted significant changes to airport protocols, including no longer allowing transplant professionals without an airplane ticket to accompany an organ through security. As a result, organs currently travel in the cargo hold.
Action by the House promises to review and possibly reverse that long standing practice.
I applaud the actions taken by the House today. I offer my profound thanks to those working with us to make this change a reality, namely Rep. Bruce Westerman and Rep. Greg Stanton from the House Transportation and Infrastructure Committee, and their colleagues Rep. Tracey Mann, Rep. Dusty Johnson, and Rep. Beth Van Duyne, said United Network for Organ Sharing (UNOS) CEO Maureen McBride, Ph.D. Todays news is the result of collaborative efforts on behalf of patients waiting for the gift of life, while also honoring generous donors and their families. There is more work to be done as we ensure this legislation is enacted, but this is a critical step.
While not a common occurrence, any logistical delays heighten the risk that an organ cannot be transplanted. The post-September 11 relegation of organs to the cargo hold created challenges navigating cargo hours and cargo lock-out times – the cut-off time for receiving shipments before the scheduled departure of an aircraft. Not all airlines accept cargo, so options are limited for transporting organs by air, especially to areas served by smaller, regional airports. Any organ not ultimately transplanted represents a profound loss, both for the selfless donors family and the patient waiting, said Dianne LaPointe Rudow, ANP-BC, DNP, FAAN, President of UNOS. Our donation and transplant community is called to honor the gift of life, and that commitment includes not only publicly identifying the issue, but seeking substantive solutions to address it. We owe our patients nothing less.
The provision included in the House version of the FAA reauthorization bill is the result of ongoing advocacy by UNOS, Organ Procurement Organizations (OPOs) and other members of the nations organ donation and transplant community. Since December of 2022, UNOS has engaged with the FAA leadership, the Transportation Security Administration (TSA), the Department of Transportation (DOT), and members of both the House and Senate to pursue this reform.
The organ donation and transplant community rallied behind this cause, knowing that it represents major progress for our patients and selfless donors, said Jerry McCauley, M.D., M.P.H., Immediate Past President of UNOS. This change is also a cornerstone of the UNOS Action Agenda, a series of improvements we know will strengthen the U.S. donation and transplant system. To further reduce risk of delay, damage or loss in organ transport, UNOS is recommending changes in the next contract for the Organ Procurement and Transplantation Network that would require the use of physical trackers for unaccompanied donor organs recovered for transplant, and the establishment of a centralized organ tracking system.
The Senate Commerce Committee could mark up its reauthorization legislation as soon as next week. The Senate provision would require the FAA to establish regulations ensuring that donor organs transported via commercial flight can once again travel in the planes cabin, as opposed to traveling in cargo. We look forward to supporting the passage of the provision in the Senate Commerce Committee and on the Senate floor, said McBride. Sen. Maria Cantwell, Chair of the Senate Commerce Committee, Sen. Ron Wyden, Chair of the Senate Finance Committee, and Sen. Ted Cruz, Ranking Member of the Senate Commerce Committee, are supporters of the Senate provision.
Actions to move organs back to the airplane cabin and out of cargo were widely endorsed by the donation and transplant community, including the American Association of Kidney Patients, American Foundation for Donation & Transplantation, American Society of Histocompatibility and Immunogenetics, American Society of Nephrology, American Society of Transplantation, American Society of Transplant Surgeons, Association of Organ Procurement Organizations, Donate Life America, Donate Life Virginia, Kidney Care Partners, Kidney Transplant Collaborative, National Kidney Foundation, Nationwide Organ Recovery Transport Alliance, North American Transplant Coordinators Organization, Organ Donation Advocacy Group, Renal Physicians Association, Transplant Recipients International Organization, Transplant Families, Transplant Unwrapped, and Waitlist Zero.
Congress will need to advance reauthorization legislation before the current FAA authorization expires on September 30, 2023.
United Network for Organ Sharing (UNOS) is the mission-driven non-profit serving as the nations transplant system under contract with the federal government. We lead the network of transplant hospitals, organ procurement organizations, and thousands of volunteers who are dedicated to honoring the gifts of life entrusted to us and to making lifesaving transplants possible for patients in need. Working together, we leverage data and advances in science and technology to continuously strengthen the system, increase the number of organs recovered and the number of transplants performed, and ensure patients across the nation have equitable access to transplant.
United Network for Organ Sharing
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United Network for Organ Sharing