Selective Recertification of Pilots Who Have Undergone a Cardiac Transplant

Area of Science:

• Aviation Medicine
• Cardiology
• Public Health

Background:

• Federal Aviation Administration (FAA) policy since 2007 allows heart transplant recipients to seek third-class medical recertification.
• This policy enables pilots with cardiac transplants to potentially return to flying.
• The study addresses the safety implications of this recertification pathway.

Purpose of the Study:

• To evaluate the safety of Federal Aviation Administration (FAA) third-class medical recertification for pilots post-heart transplant.
• To determine if any adverse aviation or mortality outcomes occurred in this specific airman group.
• To assess the long-term safety and efficacy of the FAA's special issuance policy for pilots with cardiac transplants.

Main Methods:

• Data collected from the FAA Document Imaging Workflow System identified pilots with cardiac transplants since 2007.
• Medical and safety outcomes were analyzed using the National Transportation Safety Board (NTSB) accident database.
• The Centers for Disease Control and Prevention (CDC) National Death Index was used to track mortality.

Main Results:

• Sixteen of 36 heart transplant recipients were recertified at the third-class level; 20 were denied.
• No aviation accidents or deaths were recorded among the 16 recertified pilots.
• Three deaths occurred in the group of 20 pilots denied certification, with 16 denied for incomplete information.

Conclusions:

• The Federal Aviation Administration (FAA) policy for third-class medical recertification of heart transplant recipients appears safe.
• Allowing these pilots to resume flying does not compromise aviation safety.
• Recertification should continue via the special issuance system, not BasicMed, to ensure ongoing safety oversight.