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Moonshots aren’t uncommon in either aerospace or biotech, but Martine Rothblatt may be unique in having wild ambitions for both. The United Therapeutics (UT) CEO envisions a not-too-distant future in which specialized 3D printing techniques will enable an unlimited supply of human organs, which will be delivered to transplant centers not with conventional helicopters — as many organs are moved today — but instead with zero-emissions eVTOL aircraft.
It’s a dream that would be easy to dismiss as impractical, maybe even a little wacky, if United Therapeutics weren’t making tangible progress toward achieving it. The company has already modestly increased the organ supply using ex vivo lung perfusion, which makes it possible to restore some damaged donor lungs that would otherwise be unsuitable for transplant. As it works to develop bioprinting technology in collaboration with 3D Systems, it is pursuing xenotransplantation — the transplanting of animal organs into humans — as an interim step.
In October, it was revealed that a genetically modified pig kidney from UT subsidiary Revivicor was successfully attached to a human body for two days, functioning normally without triggering rejection. While opinions varied on the medical significance of the procedure, the demonstration was widely perceived as important for building confidence in xenotransplants.
Also last month, UT subsidiary Unither Bioelectronics announced the first delivery of donor lungs by drone, from Toronto Western Hospital to Toronto General Hospital. The short hop of about 1.5 kilometers (just under a mile) across the center of Canada’s most populous city didn’t offer meaningful time savings, but it did serve as an essential proof of concept that will lay the groundwork for longer, beyond visual line of sight (BVLOS) flights in the future.
“Distance was not of the essence for the Toronto demonstration, but instead flying within that [complex urban] environment,” explained Mikaël Cardinal, an aeronautical engineer who was pursuing his own eVTOL project at a company he co-founded, Zenith Altitude, before joining Unither Bioelectronics full time in 2018. Now vice president of program management for organ delivery systems, Cardinal said the Toronto flight — which functionally carried a life on board — was accomplished under Nav Canada oversight without shutting down any airspace or city streets. “We believe that if we can succeed there, we can succeed [in other places] with lower ground risk and air risk,” he told eVTOL.com.
Unither used a small hexacopter drone for the Toronto demonstration, but the company is also making progress with larger eVTOL aircraft behind the scenes. At its headquarters in Bromont, Quebec, Unither has been conducting testing with a modified EHang EH216 autonomous aerial vehicle under a special flight operations certificate from Transport Canada since August 2020. According to Cardinal, his team has collaborated with EHang to develop a customized ground control station and compatible avionics for the two-seat eVTOL, and expects to fly it BVLOS in the next 12 months.
“[The Toronto demonstration] was not BVLOS, but it proved that it could be achieved readily — having a 4G ground supporting infrastructure that maintains the telemetry data in a robust manner with several ground control stations,” Cardinal said. “So I think that technology is there and we’ve demonstrated that it could be used in a safe manner for longer-range flight very soon.”
China-based EHang is one of three eVTOL makers that have relationships with United Therapeutics to develop certified aircraft for future organ transport; the others are California-based Tier 1 Engineering, which is developing an electric version of a Robinson R44 helicopter, and Beta Technologies of Vermont, which is developing the lift-plus-cruise Alia for missions of up to 250 nautical miles (460 kilometers). Along with smaller drones like the one used in Toronto, some combination of these aircraft could eventually be used to transport organs across varying distances from UT facilities to transplant centers, with or without onboard pilots.
UT’s role extends far beyond that of a typical customer. Cardinal said his team of around a dozen people is working closely with all three companies not only to ensure they understand UT’s requirements, but also to provide engineering and prototyping support. “We’re working super hard to help our contracted eVTOL developers to succeed in whatever capacity we can,” he said.
A Beta Technologies spokesperson told eVTOL.com: “United Therapeutics was our first customer and Martine, Mikaël, and the team there have been an instrumental part of Beta’s journey. We designed Alia with highest-value cargo in mind — life-saving organs. Our work together has pushed us to create the safest, most reliable aircraft, and challenged us to think holistically about what an end-to-end solution really looks like for a critical mission. We’ve made exceptional progress already, and we’re gratified to continue partnering with UT to support the vital work they’re doing.”
According to Cardinal, if UT achieves its bioprinting goal, it could ultimately need to deliver around 250 organs per day — which will require a lot of aircraft. The company signaled as much back in 2016, when it announced a 15-year agreement with EHang that would see it purchase up to 1,000 eVTOL aircraft as Manufactured Organ Transport eHelicopters, or MOTHs. Because EHang has yet to certify a passenger-carrying aircraft, that’s not a firm order: “The nature of our business, we cannot of course commit to a large number of aircraft without them being compliant to what we need,” Cardinal explained.
Nevertheless, UT’s ongoing support of EHang could give it a critical on-ramp in the North American market, where a number of observers have doubted the company’s certification prospects. An EHang spokesperson told eVTOL.com that the ongoing EH216 trial flights in Canada convey “a positive signal from global regulators to establish a supportive and sustainable regulatory environment for the UAM [urban air mobility] industry. As a leader in the industry, EHang will continue to work with our customers and partners to provide safe, autonomous, and eco-friendly air mobility solutions to the world.”
Cardinal said that while “there is definitely a lot of work to be done with EHang,” that is true for all eVTOL developers at this stage of the industry. “I don’t think anyone could say right now that they have a certifiable configuration in terms of aircraft design. There are certainly compelling arguments to favor some eVTOL designs out there, but I think that in the end, nobody really knows the answer, and we might be surprised about the outcome,” he said.
For that reason, he continued, United Therapeutics is “tech agnostic” when it comes to aircraft platforms, and happy to support three very different approaches to environmentally responsible organ transport.
“If we believe that certain technology could help further the business of serving more patients in the future, we want to give equal chance to anyone [who] is serious in the business to succeed,” Cardinal said. “My job is to help those partners succeed.”