Kidneys and Gyros in Pittsburgh

Last week I met David and Rob at Hanscom Field to prepare David’s airplane for a trip up to Lebanon, New Hampshire. The trip started when Rebecca Burkes in St. Louis wanted to donate a kidney to her fiance but they did not match, while Cathy Richard in New Hampshire wanted to donate a kidney to her sister-in-law (it might be that women are disproportionately donors worldwide, e.g., in Switzerland, Nepal, and the U.S.) but they did not match. To minimize transportation time, the St. Louis kidney would be flown to Pittsburgh and we would do the exchange there, then rush back to Dartmouth medical center where the same team of surgeons that had removed a kidney in the morning would be waiting to install the St. Louis kidney in the afternoon. If all went as planned, this would be the very first nationally-coordinated kidney swap (registry). Similar paired donations have occurred, but they have been done regionally and never over as great as distance.

The forecast was for gusty winds, cold temperatures, and snow showers, but we expected David’s six-seat twin-engine business jet to be up to the task. The main risk in the winter time is icing and dry snow does not tend to stick to the wings and form ice. The plan was for David and I to serve as the flight crew and Rob, an experienced and capable turboprop pilot, to handle cabin safety and assist with ground handling. David, Rob, and I had all previously volunteered for Angel Flight (press release), but this was our first involvement with an organ transplant.

We landed uneventfully in Lebanon where the guy running the front desk eyed us suspiciously. He kept noting that usually these organ flights are paid for or “commercial” and those folks paid various landing or ramp fees. He apparently failed to note that our plane did not have any of the required signage for a Part 135 charter aircraft, though from his point of view David’s willingness to donate five hours in a plane whose operating cost is too painful to calculate probably did border on insanity. We were saved from further scrutiny by the arrival of Cathy Pratt, a nurse who has served as Dartmouth-Hitchcock’s transplant coordinator for many years. She carried a cardboard box about 1.5’x1’x1′ in size with an elaborate label on the side. Rob briefed and settled her into the back while David and I fired up the plane and departed Runway 36. With a call sign of “Angel Flight 1WL”, Air Traffic Control cleared us more or less direct to the destination airport, KAGC. I was mildly disappointed because the GPS RWY 28 approach contains an initial approach fix called “HOMEE” and I wanted to hear the controller say “cleared direct HOMEE”.

Despite some wind shear from the 22-knot gusts, we landed uneventfully and parked at Corporate Air around noon. The temperature was about -4C and it felt much colder. Since David is from Montreal, I decided that I should go inside to make myself some hot chocolate and leave him to install the engine covers.

The turboprop coming from St. Louis wasn’t due until 2 pm, so we borrowed a car and drove to a Greek restaurant where Rob treated us all to the gyro plate special and Cathy answered our questions about transplants (kidneys can survive at least 24 hours packed in ice; they have never lost a kidney in transit, even when entrusted to a taxi courier; it costs $20,000 to remove a kidney and $60,000 to install one; they would not have done this particular donor swap if we had not volunteered to fly, since the commercial airline links are too complex and the cost of charter is too high; Medicare pays for all costs even when the recipients are younger than 65; they do about 100 operations per year at Dartmouth). When we got back to the Allegheny County Airport, the inbound kidney had shown up on the flight tracking Web services and was about 30 minutes away. We got the airplane ready. Out of the corner of my eye I saw a King Air land on the runway and taxi off towards another part of the airport. Snow was blowing sideways down the ramp and I thought “there can’t be that many King Airs who want to come to this airport in this weather; our kidney is on that plane and somewhere else on the field”. I had the front desk gals at Corporate Air call up their counterparts at Voyager and ask “Do you have any kidneys there?”. The answer turned out to be “yes” so we borrowed the crew car again and drove to the other side of KAGC where Cathy hugged the nurse from Barnes-Jewish (Rob and I did not hug the King Air pilots), labels were carefully compared, and we rushed back to Corporate Air. As we were taxiing out we heard the King Air pilots talking to ground control and preparing their own departure to St. Louis.

Rob assisted Cathy with the Iridium phone to update the folks back at Dartmouth and we landed about 1.5 hours later to find a car waiting for her and the kidney. We wished them well and departed home for Bedford just as the sun was setting.  It was -3C and gusting 25 knots when we landed. Cathy followed up with us the next day to let us know that all four individuals were doing well.

A friend in the hangar asked how the day had gone. I replied “We managed to get lost at the Allegheny County Airport”.

Separately, here’s another news article about the intersection of medicine and aviation: “Pilot duped AMA with fake M.D. claim”.

[Update: Some photos… http://philip.greenspun.com/images/20101206-kidney-transplant/ ]

5 Comments

  1. Stephen

    December 14, 2010 @ 8:16 am

    1

    Just wanted to say, much respect to you guys for donating your time and expertise to these flights. You are all menschen!

  2. philg

    December 14, 2010 @ 11:31 am

    2

    Stephen: Thanks for the kind words. We may have to translate the Yiddish for Rob…

  3. Bas Scheffers

    December 15, 2010 @ 5:36 am

    3

    Excellent use of private GA “toys for the rich”. Luckily we know better.

    Unfortunately I have another year or two to go before Angel Flight will consider me. Can’t wait. I have several friends who regularly do flights for them and find it very rewarding.

    Keep up the good work!

  4. Joshua Levinson

    December 15, 2010 @ 4:24 pm

    4

    Congrats on a successful mission! You are indeed Menschen.

    My random fiscal view of the day:

    According to the manufacturer’s (ha ha) estimates, the direct operating costs of the bird, while under warranty, are $650 an hour. Conklin & de Decker say more like $850, that’s still assuming pretty high usage rates. Assume closer to $1000. That puts 5 hours at $5000, plus the opportunity cost of a few skilled professionals taking a day off from otherwise contributing to our flagging GDP.

    Based on what you said above about the costs of the surgery, the organ transportation cost is less than 10% of the actual medical operation. All in all, the whole deal is probably revenue positive, in that the recipients will surely earn more in the rest of their lifetimes than the operation cost.

  5. David Wihl

    December 16, 2010 @ 11:06 pm

    5

    Josh, Slate agrees with you. Each transplant saves $90k for medicare, so by donating time, not only are two lives saved, but there are significant economic benefits.

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