*Purpose: Organ transportation has yet to be substantially innovated. Cold ischemia times (CIT) for kidneys are too long, and prolongation of CIT leads to delayed graft function, primary non-function, and excessive financial cost. If organs could be moved by drone, instead of ill-timed commercial aircraft or expensive charter flights, lifesaving organs could be transplanted more quickly, yielding better patient outcomes. Despite suggestions that regulatory burdens were prohibitive, we hypothesized that drone organ transportation was feasible.

*Methods: A modified, six-rotor UAS was used to model situations relevant to organ transportation. To monitor the organ, we developed novel technologies that provided real-time organ status using a wireless biosensor combined with an organ global positioning system. Informed by the first flight, we performed key informant interviews (KIIs) with the leadership from 4 OPOs, a policy maker (US Senator, Maryland), drone engineers, and the Federal Aviation Administration (FAA) to learn about barriers to entry for large-scale organ drone use in the United States.

*Results: Fourteen drone organ missions were performed. Temperatures remained stable and low (2.5°C). Pressure changes (0.37-0.86 kPa) correlated with increased altitude. Drone missions were associated with less vibration (<0.5 G) than with with fixed wing flight (>2.0 G). Peak velocity was 67.6 km/h (42 m/h). Biopsies of the kidney taken prior to and after organ shipment revealed no injury resulting from drone transport. The longest flight was 3.0 miles, modeling inner city inter-hospital flight. Informed by the above, OPO leadership from the West, Midwest, NE, and Mid-Atlantic were interviewed. All parties felt drones could reduce CIT and help patients, while reducing cost. A US Senator KII revealed primarily public safety concerns, but that organ drones were appealing presuming FAA and medical approval. Engineers suggested that regulatory, not technological barriers were their primary concern and that drones could travel >1000 miles and that payloads now exceed 500 lbs. The FAA has suggested a COA waiver system for organ transplants may be possible given their emergent nature.

*Conclusions: Organ transportation may be an ideal use-case for drones. Organ drones may be able to reduce CIT and improve organ quality, while reducing cost. KIIs of transplant stakeholders suggested that organ drone transportation is a viable option at the timeline to adoption may be shorter than expected.

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