Hello Paul and Group,

I'm afraid we are back to 'knee jerk' reactions to what is an impossible
situation.

First of all it is only heart, and therefore heart/lung and lung, transplant
units that are under consideration for closure. It does not involve liver,
kidney and pancreas units. On this basis those hospitals under consideration re
heart transplants will still provide their other transplant facilities.

The impossible problems are that there are insufficient donated hearts and
heart transplant surgeons to support 7 heart transplant units.

Last year there were 191 heart transplants recorded in the UK. To maintain a
high standard of operating excellence a heart transplant unit should perform at
least 50 heart transplants a year and should have 5 heart transplant surgeons
(figures given by the Royal College of Surgeons of England). Therefore it is
only possible to sustain 4, out of 7, heart transplant units. Only 2 of the 7
heart transplant hospitals presently meet the requirements of number of
transplants and surgeons. Another requirement is the transplant hospital should
have multiple medical speciality capabilities and only one of the two meets that
requirement. These levels of numbers and capabilities are regarded as necessary
to optimize the transplant outcome for a transplanted patient.

However the pre and post heart transplant care would still be provided by the
hospitals that previously had heart transplant facilities.

Because of the insufficient number of hearts for transplantation and surgeons
to transplant them, then if the person having a heart transplant wants the best
transplant outcome, there has to be fewer heart transplant units.

John E