Organs shouldn’t be transported in airline cargo. Here's why.

Many people avoid checking their luggage to avoid potential loss and delays. So why does the U.S. ship lifesaving, donated organs for transplant in cargo?

The federal government confirmed that current federal regulations do not prohibit unaccompanied organs from flying above the wing. However, the government agreed it could improve its communications to airlines and airports to clarify this. UNOS appreciates this important clarification.

Before the attacks on September 11, 2001, donor organs were transported in the cabin of commercial flights under the watchful eye of the flight crew before being delivered directly to transplant professionals.

The attacks prompted protocol changes at airports, and since then, organs have been transported with cargo. Today’s misunderstandings of the rules have prevented unaccompanied organs flying in the cabin, so precious organs are moved across the country in the cargo hold.

Transporting organs as cargo is a fundamentally bad practice.

It requires more logistical planning and does not lend itself to the time-sensitive nature of organ transplantation, where every second counts. Donor organs must be transplanted within a specific and limited period of time to patients in need 365 days a year.

Organs transported by cargo must arrive at the airport 60 to 120 minutes before a flight departure. If an organ arrives after the cut-off time, it cannot be transported on that flight. Also, airline cargo offices have highly variable hours, and if an organ arrives at its destination on time but the cargo office is closed, it cannot be collected by a courier.

Logistical delays heighten the risk that a viable organ cannot be transplanted. According to the nation’s Organ Procurement and Transplantation Network, 2.5% of unused organs are due to transportation issues.

For all of these reasons, UNOS is working to ensure organs can be transported in the cabin of airplanes.

As a result of UNOS-led advocacy, Congress demanded the U.S. Department of Transportation and the Federal Aviation Administration convene a working group to fix this issue. That group published recommendations in May 2025.

Here’s the bottom line

Lifesaving organs should not be relegated to airplane cargo bays, where they are more prone to be lost or delayed because of cargo staffing limitations. Transporting lifesaving organs in airplane cabins ensures that they will be handled with care and avoid damage, delay or loss, which will help more people get the transplant they need.

UNOS looks forward to the airlines’ and federal government’s implementation of the FAA Organ Transportation Working Group recommendations to once again transport organs in the most efficient and responsible manner: in the aircraft cabin. While it’s the responsibility of organ procurement organizations – not UNOS – to transport organs, UNOS is committed to making this change to improve patient outcomes and ensure all organs can be transported and transplanted quickly and safely.