Commercial Airlines as a Viable, Safe and Cost Effective Way for Transporting the Donor Hearts across the Country: Single Center Experience

Abstract

Purpose Worldwide private chartered jets are used to transport the donor heart. The main limitations in using private jets are costs incurred and safety. Commercial airlines can be a cost saving and safer alternative. We at our center transported the donor heart from other cities using both commercial and private jets. The purpose of this study is to evaluate the feasibility, cost effectiveness and safety of transporting the donor heart by commercial airlines; we have also compared the outcomes between both the groups. Methods Single center retrospective analytical study; study period March 2014 to September 2018. Cases in which the donor heart was airlifted from another city are included. Depending upon the modality used they are divided into two study groups, Group A- Commercial airline, Group B- Private jet. The following data is collected and compared, distance of the donor city from our center, cold ischemic time spent on organ transport, overall ischemic timings, events during the transport (delay, cancellations, safety issues, organ wastage), cost incurred and recipient outcomes. Results A total of 116 donor hearts have been transported by air during this study period, 74 by commercial airlines and 42 by private jet. The distance range is comparable between the groups: Group A (350 to 1350 kilometers) Group B (140 to 1540 kilometers). The ischemic time by the time the heart reached the recipient hospital for both the groups is as follows, Group A (135 to 285 minutes) Group B (90 to 302 minutes). The mean total ischemic time is 235 minutes for Group A and 242 minutes for Group B. The cost for the organ transport is as follows; Group A (US $ 120 to 3400: median - 1375) Group B (US $ 6850 to 27350: median - 13655). There were no unexpected delays, cancellations, safety issues during the transport by both the commercial airlines and private jet. No donor organ had to be discarded because of the issues due to the transport (commercial airlines or private jet). None of the patients in either of the groups had graft dysfunction requiring mechanical circulatory support. Conclusion Transporting the heart by commercial airlines is feasible and safe. The cost incurred in the transport by commercial airlines is around 10% in comparison with private jet. Well planned organ transport by commercial airlines is a reasonable alternative under appropriate circumstances.