--- In BODY-UK@y..., body@a... wrote:
> Hello Paul and Group,
>
> I'm afraid we are back to 'knee jerk' reactions to what is an
impossible
> situation.
>
> 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

This is nonsense. Surgeons tell us that the technical procedure
involved in cardiothoracic transplant is fairly straightforward. In
fact, because the transplant surgeons do some of the most complex
surgery around, they use all the necessary skills anyway. In fact
one surgeon in Birmingham recently reviewed his operating list over a
period of two weeks, I think, and found that every day he had carried
out operations which were technically more complex than a
transplant. The skills are there and are kept honed by involvement
in regular surgery. I doubt if those skills are going to be any more
improved by a surgeon doing an average of 10 transplants a year.


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.

Yes! And one of those hospitals has a cardiothoracic transplant unit
that they are proposing to close. Birmingham admittedly only has 3
surgeons at present, but it is the largest and busiest centre for all
solid organ transplants in Europe, it has just opened the largest
and most modern cardiac critical care unit in Europe, and it has one
of the highest transplant success rates in the UK. Unfortunately,
because it covers much or rural England (actually an area larger than
Denmark,it's organ catchment area produces fewer organs than some
other centres, but this could be changed by a slight change in the
catchment area. Such is the working relationship between collegues in
different disciplines that all transplant services would suffer if a
whole speciality were takeen away.

There is no logic in closing this unit - none at all, except of
copurse for the unwritten law that the south east must have more of
everything despite the fact that less than a quater of the population
are served by hospitals in that area. Why else would they keep two
centres (Brompton and Papworth) open when they are so close to each
other? >


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

This is not what patients are being told, and in all the
documentation I have seen there has been no suggestion that this will
be the case. We are being told that our follow up has to be at a
transplant centre, usually the one where the tx took place. This
makes sense as that is where the expertise is.Imagine having to
travel from Devon to Manchester or London every couple of weeks for a
check up!.

The whole situation is a mess, and I suspect that at the end of the
day it will be the patients who are going to suffer.

Mike Newbold