Many deceased-donor and living-donor kidney transplants (KTs) rely on commercial airlines for transport. However, the COVID-19 pandemic has drastically impacted the commercial airline industry. To understand potential pandemic-related disruptions in the transportation network of kidneys across the United States, we used national flight data to compare scheduled flights during the pandemic versus 1-year earlier, focusing on OPO pairs between which kidneys historically most likely traveled by direct flight (High-Volume by direct Air transport OPO Pairs, HVA-OPs). Across the US, there were 39% fewer flights in April 2020 versus April 2019. Specific to the kidney transportation network, there were 65.1% fewer flights between HVA-OPs, with considerable OPO-level variation (IQR 54.7%-75.3%, range 0%-100%). This translated to a drop in median number of flights between HVA-OPs from 112 flights/week in April 2019 to 34 in April 2020 (p<0.001), and a rise in wait time between scheduled flights from 1.5 hours in April 2019 (IQR 0.76-3.3) to 4.9 hours in April 2020 (IQR 2.6-11.2) (p<0.001). Fewer flights and longer wait times can impact logistics as well as cold ischemia time; our findings motivate an exploration of creative approaches to KT transport as the impact of this pandemic on the airline industry evolves.
This article is protected by copyright. All rights reserved.