World-famous Papworth heart transplant hospital in trouble

Nov 5 2007

A hospital in Britain which has been at the forefront of heart transplant surgery ever since it carried out the UK's first successful operation in 1979, is in trouble.

The world-famous Papworth hospital near Cambridge has suspended all heart transplants while an investigation is carried out into the high number of patients who have died after surgery.

Surgeons at Papworth say a national shortage of organs means they are being forced to use imperfect hearts, kidneys and livers from seniors.

According to Chris Rudge, the head of the National Health Service transplant agency, UK Transplant, surgeons were resorting to transplanting hearts from donors who had died in their sixties and in one instance a liver was used from a woman who died on the eve of her 85th birthday.

The revelations come after the news of the suspension of heart transplant surgery at Papworth.

Rudge says he had no reason to believe that surgeons at Papworth used hearts that were less suitable than those transplanted at other units, but rather that fewer patients would die if higher quality organs were used nationally.

This year seven of the 20 adult heart transplant patients have died within 30 days of their operation and the family of one say their relative was given two damaged hearts in succession.

Apparently the average age of organ donors has been increasing from age 40 in 1997-08, to 44 in 2006-07.

Papworth Hospital NHS Foundation Trust says the UK average death rate is 10% and its normal rate is 7%, but the mortality rate at Papworth has indeed soared from 7% to 35%.

Experts say the sad reality is that some patients do not survive transplantation and persistent technical error by the transplant team though possible, is not thought to be very likely.

As a rule four surgeons are involved in removing and transplanting the organ and problems usually emerge quite quickly.

While fewer and fewer hearts are becoming available the quality of donor organs could well be an issue and improved techniques mean surgeons can use hearts which previously would have been rejected.

The most likely problem could be the poor health of the recipients as patients are now spending longer on waiting lists which means they become sicker.

The facilities at Papworth may also be a factor as the services are currently provided on a cramped site of buildings, and the hospital says many were not designed for the delivery of modern healthcare and this could compromise the high standards and patient outcomes for which the hospital is renowned.

Experts say regardless how skilled the surgical team are, and despite the huge advances that have been made, things still go wrong and heart transplantation remains a high-risk procedure carried out on extremely ill patients.