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Logo of bmjThis ArticleThe BMJ
 
BMJ. 2007 November 10; 335(7627): 955.
PMCID: PMC2072034

High death rate among heart transplant recipients prompts investigation

Heart transplantations have been suspended at one NHS trust, pending an investigation into why mortality among patients undergoing the procedure there has risen to three times the national average.

Papworth Hospital NHS Foundation Trust near Cambridge raised the alarm itself after a routine audit showed that since the beginning of this year seven of 20 people who have received a heart transplant died within 30 days of the procedure.

This death rate of 35% is well above the national average of 10% and much higher than the trust's usual 7%.

The Department of Health has now asked the health services watchdog, the Healthcare Commission, to carry out a preliminary review, which will take about two weeks to complete.

The review will:

  • Look at individual case notes of the patients who died since January to check the quality of care and see whether they have any factors in common
  • Consider how care is provided to patients throughout the whole patient pathway
  • Review the action that has already been taken by the trust to try to identify possible causes for the rise in mortality.

The results, including any recommendations for corrective action, will be reported to the chief medical officer for England.

Papworth is one of five UK centres that carry out heart transplantations, and it has a good reputation as one of the country's top heart and lung transplantation centres with excellent postoperative survival.

It received a score of “excellent” in the Healthcare Commission's 2006-7 annual health check for its quality of services and use of resources.

A trust spokeswoman said that the review concerned only the heart transplantation programme. All other services, including lung transplantation, would continue as normal. Only a few operations would end up being suspended, she added.

“During the review, heart transplants at Papworth will be suspended,” she said. “We would normally perform one or two heart transplants in a two week period, so only a small number of patients are affected.”

A spokeswoman for the Healthcare Commission said that it was unable to comment until the review had been completed.

Peter Weissberg, medical director at the British Heart Foundation, said, “Despite the huge advances that have been made, heart transplantation is still a high risk procedure carried out on extremely ill patients.

“Potential heart transplant patients should be reassured that Papworth is acting responsibly and in their best interests.”


Articles from The BMJ are provided here courtesy of BMJ Group