Effects of modification of the allocation system on ischemia duration and costs of heart transplantation

Background: In order to optimize regional utilization of transplantable tho racic organs, the seven university hospitals in North-Rhine-Westfalia have formed a transplant cooperation meanwhile approved by Eurotransplant. Metho ds: Heart transplant and organ donation activities of the cooperating hospi tals in the year before the foundation of the cooperation (period A, 7/95 - 6/96) and in the year thereafter (period B, 7/96 - 6/97) were retrospectiv ely analysed. Results: In period A, a total of 39 heart transplants and 74 heart donations were performed, whereas in period B 67 heart transplantatio ns and 78 heart donations could be achieved. The regional utilization of th e donor organs increased from 4% to 30% with a significantly shorter ischem ia time of regionally or locally allocated donor hearts than of nationally or internationally allocated ones. Conclusions: A high rate of regional or local heart transplant procedures with short ischemia times clearly demonst rate the benefits of a regionalization of heart transplant medicine for med ical as well as economical reasons.