Heart Transplantation: Larger Case Volumes Improves Success Rate

In hospitals where heart transplants are performed more frequently, the survival rates for patients undergoing surgery are higher.

A question was whether for certain surgical procedures, a correlation can be shown between the volume of services provided per hospital and the quality of treatment results. For this study, a series of commissions awarded by the Federal Joint Committee (G-BA) to the Institute for Quality and Efficiency in Health Care (IQWiG) whose rapid report on heart transplantations is now available.

The findings of the study indicate a positive correlation between the volume of services and the quality of treatment results for heart transplantations in adults. It was seen that in hospitals with larger case volumes, fewer of the transplanted patients died, both in timely association with the intervention and also with respect to the total mortality.

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‘In hospitals where heart transplants are performed more frequently, the survival rates for patients undergoing surgery are higher.’
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Heart Transplantation In Germany

Heart transplantation is indicated in case of severe cardiac failure which, despite the use of all other treatment options, is progressing and endangers the life of the patient or extremely restricts his or her quality of life. Lifelong immunosuppression is required after transplantation in order to prevent organ loss due to transplant rejection. Currently in the Eurotransplant region, the average survival time after surgery is eleven years.

In 2018 in Germany, a total of 318 heart transplantations were performed, still there was shortage of donor organs.

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Correlation Between Case Volumes And Survival

IQWiG collected data from three observational studies to investigate the correlation between volume of services and quality of treatment results for heart transplantations. All three studies analyzed this correlation only at the hospital level and not at the level of the surgeons involved in the transplantation.

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The outcomes were categorized as ‘all-cause mortality’, ‘intra- and perioperative mortality’- mortality before, during and immediately after surgery. A reduction in the number of deaths in hospitals for both these outcomes was seen in hospitals with more heart transplants per year.

The studies did not contain data for ‘in-hospital mortality’, ‘need for retransplantation’, ‘health-related quality of life’ like activities of daily living and dependence on the help of others, and ‘of hospital stay’.

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Source-Medindia