Transplantation 

Working to improve the lives of patients

The Trust’s transplant unit, based at Harefield Hospital, is the UK’s leading centre for heart and lung transplants. Our staff work closely with researchers at the Heart Science Centre which is at the forefront of research into heart disease and transplantation.

2008/09 highlights

New machine increases the donor lung retrieval rate by 50%

• In March transplant surgeons at Harefield performed their first lung transplant using a machine that improves the condition of donor lungs, making them suitable for transplantation. It is estimated that over 80 per cent of donor lungs are currently not suitable for transplant.

• The new machine, an ex-vivo lung perfusion (EVLP) system, enables surgeons to re-condition donor lungs by pumping a bloodless solution containing nutrients, steroids and antibiotics through them inside a protected chamber, outside the body. This was the first time this type of EVLP system has been successfully used in Europe. It will increase the donor lung retrieval rate by around 50 per cent and will make a difference to how potential donors are managed in intensive care, ultimately helping to save many lives. Earlier in 2009, a multidisciplinary team from Harefield had training in ex-vivo lung perfusion (EVLP) and reconditioning ‘marginal’ donor lungs at Toronto General Hospital.

Approval to provide Ventricular Assist Device services

• In July the National Specialised Commissioning Group (NCG) approved the Trust’s bid for full designation as a provider of Ventricular Assist Device (bridge to transplant) services along with four other UK cardiothoracic transplant centres. A five year activity plan has been agreed with the NCG which projects an increase of 33 per cent in the number of patients who will benefit from this form of treatment.

Karen Redmond appointed as consultant thoracic and pulmonary transplant surgeon

• In September Ms Karen Redmond was appointed to the transplant team as consultant thoracic and pulmonary transplant surgeon, following completion of specialist training in the UK and the prestigious Covidien Fellowship in Toronto. Ms Redmond’s appointment has strengthened the clinical team providing lung transplant services and her specialist skills in lung surgery will enable a number of important clinical developments to be added to the service, including both cadaveric and live lobar lung transplantation.

Harefield’s heart transplant operations given clean bill of health

• An external month-long review of heart transplant operations at Harefield gave the unit a clean bill of health. The report of the external review of outcomes in the heart transplant service, published in November 2008, found that the overall high risk-profile of patients was an important contributing factor in a small number of recent deaths. The findings of both the external review of case-notes and the Trust’s internal review were consistent with the UK Cardiothoracic Transplant Audit (UKCTA) statistical analysis, which showed that heart transplant recipients at Harefield had a higher risk-profile in 2008 compared with previous years and UK centres as a whole.

Accolades for staff:

• Transplant unit sister Helen Doyle’s presentation on caring for patients with short-term ventricular assist devices on the transplant ward, rather than in intensive care, won the award for best oral presentation at the annual conference of the British Association of Critical Care Nurses, held in York in September.