MissionGO, a provider of unmanned aviation solutions, and Nevada Donor Network, an organ procurement organization (OPO) serving the state of Nevada, have recently completed two successful test flights in Las Vegas carrying a human organ and human tissue via an Unmanned Aircraft System (UAS). MediGO provided the technological services needed for collection and communication of critical data about OPO resources and organs across the transplant ecosystem. The first flight transported research corneas in an urban environment—from Southern Hills Hospital and Medical Center to Dignity Health-St. Rose Dominican, San Martín Campusin Las Vegas—while the second flight delivered a research kidney in a flight that set a record as the longest organ delivery flight in UAS history. This flight surpassed the previous record length flight in April 2019 when MissionGO team members Anthony Pucciarella and Ryan Henderson, in their roles at the University of Maryland UAS Test Site and in partnership with the University of Maryland Medical Center, delivered the first kidney by UAS that was then successfully transplanted into a patient. Transporting an organ from donor to transplant recipient requires several data exchanges between ground and air services over long distances. This is easy on the ground, due to GPS tracking, but not reliable while in the air since GPS transmitters do not work well while in the cargo hold of airplanes. To address that gap in data transmission, MediGO and FlightAware announced a partnership in November where MediGO will integrate FlightAware aviation data and insights into MediGO’s organ logistics and monitoring system, thereby providing increased transparency throughout the organ transportation process. These test flights are designed to prove the reliability of UAS, decrease the time between organ donation and transplantation, and reduce the carbon footprint – all while expanding organ procurement efficiency and ultimately saving lives. We interviewed Dr. Joseph Scalea, Chief Medical Officer and Co-Founder of Medigo, and MissionGo’s lead pilot, Ryan Henderson. Alice Ferng, Medgadget: What are your major concerns for an organ transported in this way? Of course a cornea and kidney will be a lighter payload to carry and manage than other organs such as the heart or lungs – how long do you think it will be before we are able to transport those organs? Dr. Joseph Scalea, Chief Medical Officer and Co-Founder of MediGO: Every organ that we transplant comes with its own unique challenges, and it is extremely important to understand how transportation by unmanned aircraft systems [UAS] impacts these fragile tissues. In Nevada, we transported both corneas and a kidney – both of which were undamaged and appeared viable after these flights, further proving the efficacy of this mode of organ delivery under different flight and payload conditions. Today, UAS technologies already allow for shipments within certain weight restrictions, and over time the FAA may continue to expand those limits with the proper mitigation and risk assessments. That said, innovation within transplant and UAS continues to move forward, and with lighter more advanced equipment, hearts and lungs will someday be transported on UAS as well. Technologically speaking, these are very solvable problems as MediGO, the sister company to MissionGO, focuses on the organ monitoring space and evaluates how each form of shipment affects the viability of the organ. Medgadget: What are the main risks in using this transportation method? Dr. Scalea: There are several categories of risk for the shipment of human organs by UAS. These include: 1) Technological risk: UAS technologies have advanced fantastically in the last decade – in a nearly exponential fashion. The MissionGO team is working to minimize any risk posed by the UAS through multiple fail-safe measures and significant testing. 2) Organ safety. Organs may be exposed to different elements, either environmental or aircraft related during UAS flight, but these are understudied. For example, how temperature, pressure, and vibration related to UAS flights and other modes of transport affect the organ need more investigation. MissionGO’s chief medical scientist Dr. Joseph Scalea has published on this in the past and continues to do so in order to ensure the safety of organs moved by UAS. Medgadget: Are you working on any innovations to preserve the lifespan of the organ during its time in-flight or transport? Do the altitude changes impact the physiology of the organ or bioenergetics of the cells? Dr. Scalea: MissionGO and MediGO are truly moving the needle and are currently working together on several innovations related to preserving the lifespan of organs during a typical journey that requires multiple modes of transportation. Together we are developing technologies that not only comprehensively manage, monitor, and record the shipment process, but also ensure the quality of the organ shipment. Yes, altitude, vibration, and temperature all directly affect cell function and viability. While the altitudes at which current UAVs travel are modest, there is a need to better understand how environmental factors affect the physiology and structure of tissues in transit. Our Chief Medical Officer’s laboratory is actively studying numerous aspects of cell function, structure, bioenergetics, and metabolism of tissues exposed to environmental effects simulating organ shipment. Medgadget: What tests are performed to ensure organ viability? What would be signs that the organ was not successfully delivered? What are the transportation conditions? Temperature? Oxygen? Do you use any organ preservation solutions? Anything special about the cargo container? Dr. Scalea: There are numerous tests that transplant surgeons use to determine organ viability, including pre-recovery physiologic, blood, and imaging tests, as well as visual confirmation during organ procurement procedures. Once the organ is removed, transplant surgeons rely on histological analysis using biopsies, and less frequently on pump devices to help learn if there are challenges with blood flow and vessel resistance. In the case of innovative transport measures, to better understand how organs are affected by organ shipment, recent exciting work has shown that UAS transport did not affect the viability or architecture of UAS-shipped kidneys. However, more molecular investigations of cytoskeletal structure or cellular adhesion molecule distraction are required to better understand the physiologic mechanisms that are altered by any shipment technique, including but not limited to UAS. Medgadget: What other medical innovations are planned? Dr. Scalea: These are exciting times! We are now at the interface of geography, speed, biology, and technology. By thoughtfully addressing each of these important challenges, we will develop new technologies that benefit the world. In the near term, faster and smarter UAS combined with mechanisms that autoregulate tissue micro-environments seem like a good place to start. Medgadget: Ryan, please tell me about MissionGO and its genesis. Ryan Henderson, Lead Pilot for MissionGo: MissionGo is an aviation company providing next-generation unmanned aircraft solutions for cargo delivery and infrastructure inspections. We also offer training services for unmanned operators as well as services in the infrastructure and utility market. Over a year ago, we started having conversations with experts in organ procurement organizations, transplant centers and surgeons about the urgent need for a modernized approach to organ transportation. Because of our experience carrying mission-critical payloads safely and reliably – we jumped at the opportunity to help tackle this lifesaving, national health challenge. Medgadget: How is MissionGo working with the Nevada Donor Network and OPO? How will organs be prioritized for this endeavor? Mr. Henderson: MissionGO conducted collaborative research with its innovation partner, Nevada Donor Network, one of 58 organ procurement organizations in the U.S., to complete two successful test flights carrying human organs and tissue. The goal of these test flights was three-fold: To continue to demonstrate that unmanned aircraft are a reliable mode of transportation for life-saving cargo and that MissionGO’s UAS are safe for both the payload and people on the ground. To prove the feasibility of long-distance flights in Nevada, where many of the organs donated are currently shipped to recipients in other regions. To provide an opportunity for medical research. The MissionGO team is studying the transplant tissue architecture and cell viability before and after these flights. Medgadget: Can you tell me more about the drone and its basic tech specs? Mr. Henderson: Max weight of 55lbs. Max flight time of up to 75 minutes. Max speed 80mph. Max range of 40 miles. Medgadget: What are the payloads you’re looking at from cargo + organ (cornea vs kidney vs maybe a heart/lung block)? Cargo weight? Mr. Henderson: Anywhere from 3-12lbs Medgadget: Are there any unique technological innovations that help enable this sort of drone transportation? Mr. Henderson: This aircraft has multiple motors, power sources, and flight surface controllers to increase reliability. The latest in rotor blade airfoils maximizes flight efficiency. Medgadget: What was the distance traveled in the first (research cornea) and second (research kidney) flights? (The article mentioned surpassing the flight on April 2019). I assume it’s GPS/location tracked. Mr. Henderson: These flights were 1.7 and 10.6 miles respectively. These distances were calculated by both mapping software and onboard GPS flight logs. Medgadget: How do you ensure obstacles are avoided in its flight path (birds, etc)? Mr. Henderson: This process is handled during pre-mission planning. Unexpected obstacles are avoided by the pilot’s visual line of sight and a visual observer. Medgadget: Any contingency plans in case of electrical/mechanical failure? What about affordances for external factors that may impact delivery in-flight time and ultimately the health of the organ? Mr. Henderson: The aircraft is designed to gracefully degrade if failures occur with the final failure mode being a ballistic parachute. This aircraft can have nearly every major flight system fail and continue to fly via a backup system. Medgadget: How long will it be before this technology can be used to transport donor organs meant for transplantation? How many more tests need to be performed before that can be achieved? When can we expect that to happen by? Mr. Henderson: While we are working as quickly and safely as possible, it will ultimately be up to the FAA and medical community to agree upon the accepted safety standards set forth by current and future testing being performed by MissionGO. Medgadget: What are other exciting advancements in this space we can look forward to? Mr. Henderson: Probably the single most exciting advancement we can look forward to is working in parallel with the FAA to certify unmanned systems and open the door to larger and more complex operations. This will make it possible to access the full potential of unmanned systems to operate in population-dense areas with an unprecedented level of reliability and safety. Source