Skip to main navigation menu Skip to main content Skip to site footer
##common.pageHeaderLogo.altText##

Original article

Vol. 144 No. 4546 (2014)

Heart allocation and transplantation in Switzerland since the introduction of the Swiss Organ Allocation System (SOAS)

  • Julius Weiss
  • Franziska Beyeler
  • Franz F. Immer
  • Swisstransplant Heart Working Group (STAH)
DOI
https://doi.org/10.4414/smw.2014.14057
Cite this as:
Swiss Med Wkly. 2014;144:w14057
Published
02.11.2014

Summary

OBJECTIVE: To provide an overview of heart allocation and transplantation in Switzerland since the introduction of the Swiss Organ Allocation System (SOAS).

METHODS: This study is a retrospective analysis of SOAS data related to heart transplantation between 1 July 2007 and 30 June 30 2013.

RESULTS: During the study period, 300 patients were newly waitlisted for a heart transplant in Switzerland, 199 were transplanted and 52 deceased while on the waiting list. Of the 723 hearts offered by Swisstransplant to the three university hospitals with a heart transplantation programme (Bern, Lausanne and Zurich), 199 (27.5%) were transplanted. Of these, 183 (92.0%) were procured in Switzerland and 16 (8.0%) were offered by a foreign organ procurement organisation. Fifty-two hearts were transplanted to patients who were listed in urgent status, equalling an urgent transplant rate of 26.1%. Whereas the overall waiting list mortality was 19.0%, it was as high as 31.8% in patients older than 60 years.

CONCLUSIONS: Our study showed a growing Swiss heart transplant waiting list, as significantly more patients were newly waitlisted than transplanted. Compared with the international data, the acceptance rate of heart offers and the rate of urgent transplantations were relatively low, while the waiting list mortality was higher. The fact that the mortality was highest in candidates aged 60 and above suggests that the new generation of ventricular assist devices as destination therapy should be considered as an alternative to transplantation in selected patients.

References

  1. Swisstransplant. Jahresbericht [annual report]. Bern: Schweizerische Nationale Stiftung für Organspende und Transplantation, 2012 [cited 2014, Jan 13]. Available from: www.swisstransplant.org
  2. Deng MC, Ardehali A, Shemin R, Hickey A, MacLellan WR, Fonarow G. Relative roles of heart transplantation and long-term mechanical circulatory support in contemporary management of advanced heart failure – a critical appraisal 10 years after REMATCH. Eur J Cardiothorac Surg. 2011;40:781–2.
  3. Mancini D, Lietz K. Selection of cardiac transplantation candidates in 2010. Circulation. 2010;122:173–83.
  4. Lietz K, Miller LW. Improved survival of patients with end-stage heart failure listed for heart transplantation: analysis of organ procurement and transplantation network/U.S. United Network of Organ Sharing data, 1990 to 2005. J Am Coll Cardiol. 2007;50:1282–90.
  5. Attisani M, Centofanti P, La Torre M, Boffini M, Ricci D, Ribezzo M, et al. Advanced heart failure in critical patients (INTERMACS 1 and 2 levels): ventricular assist devices or emergency transplantation? Interact Cardiovasc Thorac Surg. 2012;15:678–84.
  6. SR 810.212.41. Verordnung des EDI über die Zuteilung von Organen zur Transplantation (Organzuteilungsverordnung EDI) vom 2. Mai 2007 (Stand am 1. Juli 2013) [organ allocation ordinance; cited 2014, Jan 13]. Available from: http://www.admin.ch/opc/de/classified-compilation/20062074/201307010000/810.212.41.pdf
  7. Schneider S, Schreiner P, Weiss J, Immer FF. Assessing the potential of international organ exchange – the Swiss experience. Eur J Cardiothorac Surg. 2011;40:1368–73.
  8. Weiss J, Hofmann SP, Immer FF. Patient Characteristics of Deceased Organ Donors in Switzerland 1998–2008. Swiss Med Wkly. 2011;141:w13265.
  9. Eurotransplant. Annual report 2012. Leiden: Eurotransplant International Foundation, 2012 [cited 2014, Jan 13]. Available from: http://www.eurotransplant.org/cms/mediaobject.php?file=AR2012.pdf
  10. Lund LH, Edwards LB, Kucheryavaya AY, Dipchand AI, Benden C, Christie JD, et al. The registry of the International Society for Heart and Lung Transplantation: thirtieth official adult heart transplant report – 2013; focus theme: age. J Heart Lung Transpl. 2013;32:951–64.
  11. Kirklin JK, Naftel DC, Pagani FD, Kormos RL, Stevenson L, Miller M, et al. Long-term mechanical circulatory support (destination therapy): on track to compete with heart transplantation? J Thorac Cardiovasc Surg. 2012;144:584–603.
  12. Wilhelm MJ, Ruschitzka F, Falk V. Destination therapy – time for a paradigm change in heart failure therapy. Swiss Med Wkly. 2013;143:w13729.
  13. Westaby S, Deng M. Continuous flow blood pumps: the new gold standard for advanced heart failure? Eur J Cardiothorac Surg. 2013;44:4–8.
  14. Aggarwal S, Slaughter MS. Ventricular assist devices for destination therapy. In: Morgan JA, Naka Y (eds). Surgical treatment for advanced heart failure. New York: Springer, 2013:137–148.
  15. Almenar L, Segovia J, Crespo-Leiro MG, Palomo J, Arizón JM, González-Vílchez F, et al. Spanish Registry on Heart Transplantation. 23rd official report of the Spanish Society of Cardiology Working Group on Heart Failure and Heart Transplantation (1984–2011). Rev Esp Cardiol. 2012;65:1030–8.
  16. Agence de la biomédecine. Procurement and transplantation of organs and tissue; 2011 data [cited 2014, Jan 13]. Available from: http://www.agence-biomedecine.fr/Procurement-and-transplantation-of,530?lang=fr
  17. Smits JM. Actual situation in Eurotransplant regarding high urgent heart transplantation. Eur J Cardiothorac Surg. 2012;42:609–11.
  18. Stevenson L. The urgent priority for transplantation is to trim the waiting list. J Heart Lung Transpl. 2013;32:861–7.

Most read articles by the same author(s)