Following an increase in the number of deaths after heart transplantation, NHS Greater Glasgow and Clyde (NHSGGC) have asked an independent group to undertake an external review of the Scottish National Heart Transplant Unit, based at Glasgow Royal Infirmary.
This decision is in line with best practice and action taken by other heart transplant units in the UK.
A team, including clinical and technical experts, will begin the review in early January 2008. It is expected to be concluded within several weeks.
During the review, heart transplants at the unit will be suspended. Organ retrieval, pre-operative assessment and post-operative care will all continue to be provided by the Scottish team. All other cardiothoracic work will continue as normal.
Routine heart transplantation is reserved for only the sickest patients with heart failure whose quality of life is very poor and who are not expected to survive more than a year on medical treatment. Those who receive transplantation on an ‘urgent’ basis do so because they are not expected to survive more than a few weeks.
Although the early mortality rate of transplantation in Glasgow is the same the UK average of around 13%, of the 11 patients transplanted this year, 4 (36%) have died within 30 days.
While the review is taking place patients awaiting transplantation in Glasgow will be transferred on to the waiting list at the transplant unit of the Freeman Hospital in Newcastle. This means those who are on the Scottish waiting list will not be denied the chance of a new heart while transplant operations are suspended in Glasgow. We have already contacted the patients on the waiting list to let them know of this temporary arrangement.
Such reviews of transplant centres are not uncommon the most recent being in Papworth Hospital whose service has now resumed.
Heart failure is a common condition, affecting about 150,000 people in Scotland. Unfortunately it imposes a heavy burden of symptoms and a high mortality which in the most severely affected people approaches 50% per annum and 100% at 5 years. By contrast the 5 and 10-year mortality rates after heart transplantation are approximately 30 and 40% respectively.
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