NHS Specialised Services

Review of recent outcomes in the heart transplant service at Harefield Hospital

This review was commissioned following concern about success rates for heart transplant patients at Harefield between April 2010 and June 2011. The review follows the Trust’s own internal investigation which did not find any one single factor associated with the deaths. The issue was first identified through the national monitoring system in place for transplant patients, which flags when mortality rates are higher than expected. Over the period under review 13 heart transplants were carried out; five of the last six recipients died within 90 days of the procedure. The review was undertaken by two eminent clinicians: Professor Robert Bonser, Consultant Cardiothoracic Surgeon, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust and Dr Jayan Parameshwar, Consultant Cardiologist and Transplant Physician, Papworth Hospital NHS Foundation Trust.

The process included:

•  Reviewing a summary report of all referrals and patients listed during that period
• Reviewing al l documentation relating to these cases
• Meeting with key staff involved in the transplant programme
• Reviewing the Trust’s own internal report and action plan
• Holding face to face meetings with Trust staff

The review showed that while the transplant service is safe overall, some of the recommendations made were similar to those made in a similar review of the heart transplant service at Harefield in 2008. The expert review’s recommendations have been accepted in full by the Trust. The Trust is also ensuring that former and current transplant patients, includ ing those on the waiting list for a transplant, are being kept informed. The NSCT, NHS BT and CTAG will continue to closely monitor outcomes at Harefield, as it does for other transplant centres throughout the country, to ensure optimal care for heart transplant patients.