The Role of Medical Air Rescue Services in Medical Transport of Organ Recipients in Poland: Organizational Solutions Supporting Transplantation Medicine
Robert Gałązkowski, Agata Pawlak, Daniel Rabczenko, Grzegorz Michalak, Michał M. Farkowski, Roman Danielewicz, Maciej Sterliński
(Department of Emergency Medical Services, Medical University of Warsaw, Warsaw, Poland)
Ann Transplant 2015; 20:627-633
The aim of this study was to analyze the use of fixed-wing air ambulance (FWAA) services in Poland during the period 2012–2013, with particular emphasis on air transport of organ recipients to transplantation centers.
MATERIAL AND METHODS: This was a retrospective, cross-sectional analysis of data derived from standard FWAA medical documentation.
RESULTS: In the years 2012–2013 there were 500 emergency (52.7%) and 447 elective (47.3%) missions. Children who were 1–10 years old comprised the single largest group in both emergency (EM) and elective (EL) missions, accounting for 17% of all flights. EM transports carried mainly patients aged 49–59 (18.5%), and 35.1% of all EM transports concerned patients with end-stage renal disease qualified as organ recipients who were transported to transplantation centers. With a total of 2278 kidney transplantations performed in Poland within the period analyzed, up to 7.8% recipients were transported by air medical services. For EL flights, the most numerous group were patients aged 1–10 (25.4%) and this group comprised mainly patients with congenital disorders (17.9%) and cardiovascular diseases (15.8%). The average flight duration was similar for both EM and EL groups (41.7±10.5 min vs. 40.4±8.7 min, respectively) (p=NS), as was the average distance covered (321.8±99.4 km vs. 310.5±87.4 km, respectively) (p=NS). In the case of patients with end-stage renal disease, the average distance and flight time were significantly longer than those for all other groups in total: 382.5±96.4 km vs. 302.6±87.3 km (p<0.001) and 74.9±10.2 min vs. 39.7±8.8 min (p<0.001), respectively.
CONCLUSIONS: The most frequent clinical indication for FWAA transport was end-stage renal disease and most of those flights were carried out as EM. The FWAA service plays a vital role in the organization of pre-transplantation transport to referral centers in Poland. This analysis supports the data for evaluation and potential changes in the Polish distribution and allocation rules for kidney transplantation.
Keywords: Aircraft, Kidney, Transplantation