Clearing the Runway for Lifesaving Organs:
FAA Releases Landmark Organ Transport Recommendations

The Association of Organ Procurement Organizations (AOPO) applauds the release of the Federal Aviation Administration (FAA) Organ Transport Working Group Final Report – a landmark step toward advancing how lifesaving organs are transported through the U.S. commercial airline system. The report, developed with input from Organ Procurement Organizations (OPOs), transplant centers, couriers, airlines, and other key stakeholders, outlines 20 actionable recommendations that can significantly reduce delays and logistical hurdles in getting organs from donor to recipient.

Each day, transplant teams rely on time-sensitive flights to deliver organs, especially kidneys, across vast distances. But outdated or inconsistent commercial airline protocols can compromise this mission. As AOPO has long advocated in Congressional letters and federal comments, improving air transport logistics is essential to honoring the generosity of organ donors and ensuring more patients receive the transplants they need.

A Shared Commitment to Modernizing Organ Transport

The FAA’s working group was created through bipartisan provisions in the 2024 FAA Reauthorization Act, thanks to leadership from Congresswoman Beth Van Duyne (R-TX) and Congressman Emanuel Cleaver (D-MO), who championed language requiring a stakeholder-led process to identify best practices for above-wing (passenger cabin) organ transport. AOPO appreciates their vision and commitment to reducing barriers for donor organs in the aviation system.

While there are currently no federal regulatory barriers preventing organs from traveling in the aircraft cabin, the decision to allow such transport rests with each individual airline. As AOPO has consistently emphasized, this lack of standardization can cause damaging delays, especially when organs miss flight cutoffs or are stranded in closed cargo offices. These risks are unacceptable when a donated organ and a patient’s life are on the line.

Recommendations Reflect OPO Realities

The FAA report reflects months of cross-sector collaboration and identifies five key focus areas: access, education, logistics, communication, and reporting. Among the most relevant recommendations for the OPO community:

• • • Priority Access & Boarding: Airlines are urged to develop expedited check-in and boarding procedures for organ couriers and to designate secure seats for organs, especially on full flights.
    • Courier and Container Identification: Standardizing labeling and tamper-evident packaging, along with matching courier letters, will strengthen the chain of custody and prevent confusion at screening points.
    • 24/7 Airline Contact and Coordination: Airlines should provide reliable, round-the-clock contact mechanisms for couriers to support last-minute flight changes and notify dispatchers and flight crews in advance of an organ’s presence.
    • MEDEVAC Call Sign Usage: Dispatchers should flag flights transporting organs, enabling pilots to request air traffic priority where appropriate, reducing delays during critical transport windows.
    • Education and Training: TSA officers, airport agents, pilots, and flight attendants often encounter organ couriers infrequently. The FAA recommends robust training and public-facing guidance to ensure all relevant personnel understand organ transport protocols.
    • Digital Information Hubs: FAA and TSA are encouraged to publish dedicated websites with up-to-date information on transporting organs, empowering OPOs, couriers, and patients to navigate the system more efficiently.

From Recommendation to Lifesaving Impact

AOPO strongly supports the report’s call for standardized processes across airlines, airports, and security checkpoints. Too often, the success of a transplant hinges not just on clinical precision, but on whether an airline gate agent or TSA officer understands how to handle an organ in transit. These recommendations chart a path toward predictability, consistency, and speed.

We also endorse the report’s vision for centralized data reporting and continuous stakeholder collaboration, ensuring the organ transport process evolves with lessons learned and emerging best practices.

Looking Ahead

While the FAA report offers a powerful roadmap, its success will depend on voluntary adoption and implementation across the aviation industry. AOPO urges the Department of Transportation, FAA, TSA, and HRSA to move swiftly to operationalize these recommendations, and calls on all airlines to act with urgency in updating their policies.

The donation and transplantation community stands ready to collaborate. The gift of an organ is time-limited and irreplaceable, and we must ensure the system transporting these gifts matches their urgency and value.

Together, we can modernize organ transport to save more lives, reduce waste, and honor the generosity of America’s organ donors and their families.

AOPO thanks Rep. Van Duyne, Rep. Cleaver, the FAA and all participating agencies for recognizing the vital role of air transport in the donation and transplantation system. We look forward to continuing our work to ensure every organ reaches the patient who needs it safely, swiftly, and securely.

Thank you,
Steve Miller, MBA, CAE
AOPO CEO