Notes 20th June 08

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					              West Yorkshire Cardiac Network Transplantation Sub-Group
           Friday, 20 June 2008. 2.00 – 4.00pm, Cedar Court Hotel, Bradford


Present:       Paul Brooksby (Chair)
               Adele Graham (WYCN)
               LipBun Tan
               Sudi Bulu
               Paul Smith

Apologies:    Hazel White, Greg Reynolds, Klauss Witte, Debbie Gibbon, Chris

Notes of last meeting: These were accepted as a true and accurate record.

Matters Arising: Dr Tan is still working on the schematics of setting up a register to
log all patients referred to him for Transplant assessment. Discussions with Peter
Truss are ongoing.

ACTION: Dr Tan to continue commencement of Register at LTHT

ACTION: Dr Tan to speak to Dr Stephen Campbell and Dr Al Mohammed re
invitation to join this group.

Specialist Commissioning: AG updated the group on information received regarding
current payment mechanisms for Transplant Assessment/work up and Transplant at
Centres. A DoH Paper does cover the definitions for all activity within cardiothoracic
transplantation as follows:

    Assessment for transplantation including investigative and other operative
    Surgery to implant donated organs
    Surgery for donation of organs including live donors (lung transplant)
    Post operative immunosuppression following transplant and anti-rejection
    Follow up and assessment after discharge

It was noted that the first point on the list (Assessment) covers only assessment for
transplant and does not include the assessment for other therapies which may be
beneficial to the patient following work up tests, also this assessment is undertaken
at the Transplant Centre and by this point local referral will have been made following
appropriate transplant assessment tests.

AG has been in touch with the Specialist Commissioning Group (SCG) and received
details of the information to be collected in order for the group to agree a way forward
and present its findings and recommendations to the SCG.
Information required:

    Present activity at LTHT and the income already received for Cardiac
     Transplant Assessment/work up.
    Numbers of CPX and their tariff linked to transplant assessment (over last two
    Numbers of other tests and their tariffs required for transplant work up (again
     last two years) over and above a PCX
    Numbers of referrals to LTHT now for Transplant work up (ie numbers referred
     06/07 07/08)

ACTION: Dr Tan to find out the information above relating to tests, tariffs and
numbers, by end of July 08

Further information required:

    To find out what other centres do in terms of assessment tests and what income
     they receive (Manchester, Sheffield and Hull)

ACTION: AG, PB and Dr Tan to investigate by using existing contacts by end
of July 08

UK Transplant Data: AG shared with the group the information from Transplant UK
regarding primary disease of patients from West Yorkshire having had a Transplant
and survival rates. The figures show that we are only slightly down in relation to the
rest of the UK based on HF prevalence and our population, estimate 45 currently
running at 35.

ACTION: AG to find out the percentage of patients transplanted in relation to
referrals from both Freeman and Wythenshaw

Criteria Update: Dr Tan brought with him the first draft of “Guidelines: Management
of Heart Failure Patients as Candidates for Cardiac Transplantation or Alternative

ACTION: Dr Tan to send these guidelines electronically to AG so that she can
forward to the whole group for comments.

The group members in attendance quickly browsed through the guidelines and
agreed to read the document in depth, and make any comments via AG.

Agreement was reached that much of the relevant background information should be
included as appendices to the guidelines so as to allow the criteria to be at the
forefront whilst allowing for more in-depth reading for those who wish. It was also
agreed that these guidelines should published via the WYCN Website
( to allow for hyperlinks.

ACTION: AG to speak to Darren Lee re website and guidelines.
Dr Tan shared with the group his thoughts for expanding on the prognosis section of
the guidelines (in an appendix/hyperlink format) to allow more understanding and
support for junior Doctors; for example a hierarchy of importance for prognostic
indicators. The group agreed that this could be useful.

ACTION: ALL Comments regarding draft guidelines to AG by end of August

Next Steps: Covering by action points above.

Date of Next Meeting: Friday, 26 September 2008, 2.00 – 4.00pm, Cedar Court
Hotel, Bradford

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