Every year, approximately 5,000 Americans die while they’re on the waiting list for kidney transplants. It’s a terrifying figure, and it’s one that’s brought into sharp relief by a second data point: That each year around 3,500 donated kidneys are discarded. Overall, according to a 2019 study published in the journal JAMA Internal Medicine, around 17% of kidneys that are donated in the United States are ultimately thrown out.
Dr. Joe Scalea, a transplant surgeon at the University of Maryland’s School of Medicine and University of Maryland Medical Center, wants to reverse this trend. And he believes that, along with cutting-edge medicine, cutting-edge technology has a big role to play. To that end, his new commercial venture seeks to do something that, just a few years ago, would have sounded totally crazy.
He’s launching a drone delivery service for transplant organs.
“If you quote me on this, I’ll totally deny I said it,” said Scalea, who is 40. “But screw it. Man, we’re just doing it, we’re just gonna do it. We’re gonna innovate this whole thing and bring this tech right to the patient. It’s what needs to happen. [And, you know what?] Maybe I’m crazy, but at least it’s shaking things up, and giving people an opportunity to rethink the way medicine can be approached.”
Like Prime Air for transplant organs
Drones have been a growing presence in skies around the world over the past couple of decades. For many people, one of the most promisingly beneficial applications of unmanned aerial vehicles (UAVs) involves “last mile” commercial deliveries.
In 2013, Amazon founder and CEO Jeff Bezos showed off the concept for Amazon Prime Air during an interview for 60 Minutes. “We can do half-hour delivery, and we can carry objects up to, we think, 5 pounds,” Bezos said. The retail pioneer has since claimed that the sight of delivery drones will one day be “as common as seeing a mail truck.”
Coming up on eight years after that 60 Minutes episode, Amazon Prime Air has yet to officially launch, while efforts from other global heavy hitters like Google, Kroger, and JD.com also remain more tantalizing sneak peeks of the future than currently available solutions. As I wrote for Digital Trends a year ago: “Companies promising drone deliveries are a whole lot like sex in high school. Everyone says they’re doing it, but hardly anyone actually is.”
Regulatory approvals are a big challenge when it comes to rolling out this technology. However, there’s also a significant conceptual one: As impressive as drone tech might be, how many scenarios are there in which a lightweight object is so vital that customers will pay a premium (it currently costs significantly more to do delivery by drone than it does to load a large number of packages of any size into the back of a truck for regular delivery) to receive it within 30 minutes, rather than the usual one or two days?
Getting a new pair of AirPods or a replacement phone charger probably doesn’t cut it. Nor does getting a couple of books or a spare pair of jeans. But medicine most certainly does.
Medical use of drones
Drone deliveries for medical usage is a compelling answer to this question. In 2015, a company called Flirtey used drones to deliver medical supplies to a rural clinic in Virginia. The startup Zipline has also used drones to deliver emergency supplies and blood. Now, Scalea’s transplant drone delivery service aims to join the pack.
The advantage of using drones in these scenarios is that it makes it possible to carry out aerial deliveries in places where either cars or trucks wouldn’t be able to get through (say, rural clinics in parts of the world without good road infrastructure) or in time-critical situations in which a patient’s life depends on medicine or some other form of treatment getting through.
When Digital Trends first wrote about Scalea’s work in 2018, he was leading a research project to investigate whether drone technology could be used for transporting organs, without damaging them. To do this, his research team put a kidney in a cooler and then flew it on test flights using a DJI M600 Pro drone. To properly measure the effects, Scalea and his laboratory developed a smart organ-monitoring wireless biosensor system to gauge the temperature, barometric pressure, altitude, vibration, and GPS position of organs as they took to the sky.
“[It’s crazy that] we know more about the shipment of something like an Amazon order for a swing set that you’re going to put up for your kids in your backyard than we do about lifesaving organs during shipment,” Scalea told Digital Trends.
Not only did the trial runs show that drone transportation did not damage the organs, but that drones might actually turn out to be safer, in terms of vibrations, than aircraft delivery.
Scalea’s startups
Now Scalea, as co-founder, has scaled that research into two separate (but linked) startups. Working with a Baltimore-based impact investor named Scott Plank, an early investor and longtime logistics expert at Under Armour, these startups seek to disrupt the organ transplant industry.
The first startup, MediGO, spins out of Scalea’s organ telemetry research with a biophysiological monitoring system that uses machine learning to optimize organ shipment practice. “Like ordering pizza online, you can now confirm a human organ’s acceptance, and learn minute by minute when the organ will arrive and its status during shipment,” he said.
It has so far been used in more than 100 transportations in the United States. One of its goals is to connect the organ donor to the recipient using actionable data. That could be what is needed to optimize organ transplant logistics, and ultimately increase the number of lifesaving human organs.
The second startup, MissionGO, is the drone delivery business that’s focused on physically transporting the organs. To date, it’s carried out a proof-of-concept test flight of more than 10 miles. This, Scalea said, is conceptually important because all the hospitals in Las Vegas fall within a 10-mile circumference. That suggests that MissionGO’s unmanned services could shuttle organs between any of the Las Vegas hospitals with their currently-operational technology.
“With drones, organs don’t have to wait for the morning airline flight,” he noted. “Organ shipment could be, quite literally, on demand. The use of drone technology might decrease the amount of time that those organs spend on ice. The beauty of this innovation is that the shorter the time the organ spends on ice, the longer and better that organ will work after it goes into the recipient [it’s] transplanted [into]. The quality of the organ goes up and access improves. We have a lot of work to do, but there seems to be great interest in what we’re doing.”
The mismatch
Death by organ failure has always been a problem. Until 1954, however, there was little that could be done about this. That year, the first human organ transplant was carried out, with surgeons at Peter Bent Brigham Hospital in Boston performing the world’s first successful kidney transplant between identical twins.
It took another several decades, until the 1980s and ’90s, for modern immunosuppression to arrive, allowing patients to be given drugs that would stop their bodies from rejecting transplant organs as alien invaders.
Now that these treatments have matured, and patients’ outcomes have improved, transplant medicine has given millions of people around the world access to lifesaving treatment. But the arrival of this technology has also highlighted problems that didn’t exist before, like the unsuitability of modern transportation solutions for things like moving organs from point A to point B.
The science that brought us organ transplantation has outpaced the infrastructure needed to support it. Rapid improvements in transplantation have also triggered a seismic mismatch in the number of people whose lives can realistically be saved by organ transplants and the number of those organs that are actually available.
A part of the solution
Scalea’s work isn’t going to solve this problem completely. The “woeful” mismatch he describes isn’t just about logistics; it’s also about the number of transplant organs available.
For that reason, scientists have explored processes such as perfusion decellularization and recellularization, in which an animal organ is stripped of any cells that could cause it to be rejected, before pumping it full of a patient’s cells to make it a viable transplant organ. Also, 3D bioprinting seeks to use additive manufacturing to, eventually, print out functioning, personalized organs that could be transplanted into patients.
However, given the very real challenge of delivering organs in a timely manner, and the difficulty in monitoring these organs’ condition as they are transported, technology like Scalea’s — and MediGO and MissionGO’s — could prove to be a game-changer.
“I’m highly passionate about innovation, science, and medicine — and bringing new technologies to the patient, not just leaving them in the lab, is how I hope to spend my career,” Scalea said. “A lot of people develop really cool ideas and technologies, and they don’t go anywhere. In this case, we’ve taken an idea, tested it, implemented it, and now we’re commercializing it to actually bring it to the patient. Together with MediGO, MissionGO, my surgical colleagues around the world, and the whole transplant community, we are trying to move the needle and save lives. I have a good feeling that we’re going to be successful.”
