Impact of the COVID-19 pandemic on commercial airlines in the United States and implications for the kidney transplant community

Alexandra T. Strauss, David Cartier, Bruce A. Gunning, Brian J. Boyarsky, Jon Snyder, Dorry L. Segev, Michael Roush, Allan B. Massie

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Many deceased-donor and living-donor kidney transplants (KTs) rely on commercial airlines for transport. However, the coronavirus-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 vs 1-year earlier, focusing on Organ Procurement Organization (OPO) pairs between which kidneys historically most likely traveled by direct flight (High Volume by direct Air transport OPO Pairs, HVA-OPs). Across the United States, there were 39% fewer flights in April 2020 vs April 2019. Specific to the kidney transportation network, there were 65.1% fewer flights between HVA-OPs, with considerable OPO-level variation (interquartile range [IQR] 54.7%-75.3%; range 0%-100%). This translated to a drop in median number of flights between HVA-OPs from 112 flights/wk in April 2019 to 34 in April 2020 (P <.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 <.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.

Original languageEnglish (US)
Pages (from-to)3123-3130
Number of pages8
JournalAmerican Journal of Transplantation
Issue number11
StatePublished - Nov 1 2020


  • clinical research/practice
  • kidney disease
  • kidney transplantation/nephrology
  • quality of care/care delivery

ASJC Scopus subject areas

  • Immunology and Allergy
  • Transplantation
  • Pharmacology (medical)


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