Drone-Assisted Organ Transport: A Scoping Review of Clinical, Regulatory, and System Readiness

Organ transport remains a critical determinant of transplant success, with delays during transfer prolonging cold ischemia time (CIT) and increasing the risk of delayed graft function or organ discard. Uncrewed aerial vehicles (UAVs) have emerged as a potential means to enhance the speed, predictability, and resilience of transplant logistics. This scoping review synthesized global evidence from 2010 to 2025 across biomedical, engineering, and regulatory domains, mapping research within six key themes: time sensitivity and clinical evidence, integration with preservation and perfusion technologies, technological and infrastructural readiness, regulatory and ethical frameworks, economic and environmental feasibility, and public and professional preparedness. Case studies from North America, Europe, and Asia demonstrate that UAVs can safely deliver donor organs while maintaining temperature and structural stability, with successful clinical transplantation reported. Their current value lies primarily in short-range transfers where direct routing and rapid handover are feasible; however, advances in heavy-lift aircraft, autonomous traffic management, and connected perfusion systems may soon enable longer, more complex missions. Major barriers include restrictions on beyond-visual-line-of-sight (BVLOS) operation, payload and endurance limitations, uncertain liability frameworks, and incomplete hospital-side infrastructure. Future priorities include comparative clinical and economic trials, harmonized international standards, and certified medical air corridors integrated with national allocation systems. With appropriate regulation, interoperability, and clinical validation, drones could become a safe and sustainable extension of existing transplant networks-improving efficiency, equity, and ultimately, patient survival.