Evaluation on the Use of Italian High-Speed Rail to Support Transportation Network for Transplantation Activities

Transplant Proc. 2019 Nov;51(9):2873-2879. doi: 10.1016/j.transproceed.2019.04.100. Epub 2019 Oct 9.

Abstract

Background: One of the main activities connected with transplantation is the rapid and timely transportation of patients, medical teams, and human organs from donation to transplantation centers under the compliance of national guidelines and principles of quality, performance, and safety. High-speed transportation on a railway network is becoming relevant both in terms of performance and extensiveness of the service.

Methods and objectives: Our study explores the feasibility of adopting a high-speed rail network for the transportation of those organs with large cold ischemia time and those less influenced by transportation-related perturbations (ie, temperature, speed, vibrations), assessing savings and relative performance improvement. In this study, only kidneys have been considered; the transplantation database has been integrated with the national high-speed railway network and timetables. A function is implemented that allocates to air transportations those records with 1 of the 2 ends situated on islands, remote regions, and abroad, while rail transportation is preferred where constraints on capacity and compliance with cold ischemia time are met. Road transportation is still feasible for those records involving 2 adjacent regions and for intraregional transportation.

Results: The opportunity of integrated road-rail transportation in place of air or all-road transportation allows users to lower generalized costs and reduce driven distance for personnel and vehicles allocated to a regional transplantation center's fleet and staff. Savings in fleet and staff usage can serve to improve the performances at the local level.

Conclusions: The knowledge and analysis of transportation alternatives for human organs with less stringent safety and preservation criteria allow a more efficient allocation of resources both at the local and national level-without compromising quality and reliability of the system.

MeSH terms

  • Humans
  • Italy
  • Railroads / methods*
  • Reproducibility of Results
  • Tissue and Organ Procurement / methods*
  • Tissue and Organ Procurement / organization & administration
  • Transplants*