§ Mrs. Renée Short
asked the Secretary of State for Social Services if he will publish in the Official Report the text of the letter sent by Sir Henry Yellowlees to regional and area medical officers concerning the issue of priorities and finance involved in cardiac transplants.
§ Dr. Vaughan
The text of the letter dated 21 February 1980 from the Chief Medical Officer of the Department to regional medical officers and area medical officers and copied to secretaries of boards of governors of the specialist postgraduate teaching hospitals is as follows.711W
The paper on costs referred to its available on request.
HEART TRANSPLANTSAs I am sure you know, a Panel widely representative of the medical profession, advises me on all aspects of organ transplantation. In view of the recent heart transplants and attendant publicity, I felt it would be helpful to you if I passed on their advice which the Department has accepted, about the criteria which should be met before a decision is taken to carry out a cardiac transplant programme at any centre.At its meeting in February 1977 the Panel accepted that a centre planning a programme of heart transplantation should satisfy the following criteria:—
- (a) A unit should already be a centre for advanced cardiac surgery and, preferably, renal transplantation should already be taking place at the same centre.
- (b) Donor hearts of high quality should be available.
- (c) Sufficient medical surgical, nursing and technical personnel and equipment must be available to maintain both the transplantation programme and the regular cardiac surgical programme.
- (d) Adequate support services in pathology, immunology and microbiology must be readily available at all times.In February 1979 the Panel re-affirmed the above criteria and emphasised that any development should only be as part of the planned programme. The Panel also added a further criterion that a centre performing cardiac transplantation should already have carried out experimental work into immunology, circulatory support, and organ preseveration systems with and without animals.The Panel met again in November 1979, when they confirmed all these criteria and again emphasised their disapproval of heart transplants which are not part of a planned programme.At its last meeting, the Panel also considered the costs of such operations. These were very difficult to estimate but the Panel accepted that a figure of £140,000 (at 1979 prices) for a programme of eight transplants in one year was a useful indication of the likely overall costs. Enclosed with this letter is a paper, based on one which was put to the Transplant Panel, itemising costs on the limited information so far available in the Department. If you would like any further information on this please contact Dr. G. Pincherle, Department of Health and Social Security, Room 1020 Hannibal House, Elephant and Castle, London SE1 6TE, telephone 01-703 6380, ext 3414.The Department is giving further consideration to the issues of priorities and finance involved in cardiac transplantation and the wider implications for the NHS as a whole. Until the Department's advice on these aspects is available authorities are not expected to make any policy change in the direction of further heart transplant programmes.712WRegional Medical Officers and Area Medical Officers are asked to bring this letter to the attention of cardiac surgeons.