Heart Transplant

A heart transplant is an operation in which a failing, diseased heart is replaced with a healthier heart from a donor. Heart transplant is a treatment for people who have heart failure and when other treatments, like medications and other types of operations, have not worked. Heart failure can be caused by coronary artery disease, a weakening of the heart muscle (cardiomyopathy) or diseases of the heart valves. In children, heart failure is usually the result of a heart defect that existed at birth (congenital heart defect) or cardiomyopathy.

The University of Michigan Health System Heart Transplant Program was established in 1970 and continues to grow in both adult and pediatric heart transplantation. Patient survival following heart transplant at UMHS is better than the national average reported by the Scientific Registry for Transplant Recipients.

In evaluating our performance, it is important to consider several types of measures, including the volume of procedures and the success (or outcome) of the procedure. The Scientific Registry for Transplant Recipients (SRTR) provides national benchmarks for this procedure to help hospitals evaluate their performance. The graphs below demonstrate that UMHS preforms very well when compared to SRTR benchmarks.

Procedure volume is the number of times a procedure was performed and is often used to assess clinical experience and expertise. Studies have linked higher volumes with more successful outcomes for some types of procedures.

Volume of all Heart Transplant Operations

Details

Why is This Measure Important?

Health systems that perform a high number of heart transplants are more likely to have better outcomes, such as better survival rates. Unfortunately, there is no standard or agreed upon threshold that defines high volume, so it is important to consider volume along with other measures, like process and outcome measures. This is a measure of the volume, or number of heart transplants.

How is UMHS Performing?

Surgeons at the University of Michigan Health System perform an average of 36 heart transplants each year. According to the U.S. Scientific Registry of Transplant Recipients, typical heart transplant programs in the U.S. transplanted between 10 and 21 patients from July 2009 through June 2010. Our volume is high compared to the volume at other health systems, demonstrating that UMHS has considerable experience in heart transplantation.

UMHS Source: Hospital administrative data.

In this section, we evaluate the success of the heart transplants by measuring several outcomes, including patient survival. Because the severity of disease differs between patients, some patients have a higher risk of death. So, we compare our actual performance to what is expected given the risk of the patients we treat. The expected survival rate is provided by the U.S. Scientific Registry of Transplant Recipients (SRTR). For all measures except waitlist mortality, percentages that are higher than the SRTR expected rate mean better performance.

Transplant Rate
Higher Value = Better Performance

Details

Why is This Measure Important?

The transplant rate is the percentage of patients on the waiting list for transplant who received a transplant. The actual transplant rate for the University of Michigan Health System is compared to the expected rate for our institution calculated by the U.S. Scientific Registry for Transplant Recipients (SRTR). Although the SRTR expected rates are adjusted to account for the severity of illness of our waitlisted patients, the adjustment is not perfect. In this graph, a percentage that is higher than the SRTR expected rate means better performance.

(Note: The rate accounts for the amount of time patients are waitlisted and is expressed as the number of transplants per patient year on the waiting list.)

How is UMHS Performing?

The University of Michigan Health System had more transplants than expected based on the national experience in the most recent year reported. However, the difference between actual and expected rates in all four years is not statistically significant.

UMHS Source: Hospital Organ Transplant Information System.
Comparison Group Source: Scientific Registry of Transplant Recipients (SRTR).

Patient Survival Rates After Transplant - Adults
Higher Value = Better Performance

Details

Why is This Measure Important?

Patient survival is a measure of the success of the heart transplant. This measure represents the percentage of adult patients who survived 1 month, 1 year and 3 years after heart transplant. The actual patient survival rates for the University of Michigan Health System are compared to the expected rates for our institution calculated by the U.S. Scientific Registry for Transplant Recipients (SRTR). Although the SRTR expected rates are adjusted to account for the severity of illness of our transplant population, the adjustment is not perfect. In this graph, a percentage that is higher than the SRTR expected rate means better performance.

How is UMHS Performing?

The University of Michigan Health System's adult patient survival rate is higher than expected after 1 month, 1 year and 3 years after heart transplant, based on results from SRTR. The difference in all three rates is not statistically significant.

UMHS Source: Hospital Organ Transplant Information System.
Comparison Group Source: Scientific Registry of Transplant Recipients (SRTR); 1-month and 1-year survival is reported for patients who received a transplant from Jan '07 - Jun '10 and 3-year survival is reported for patients who received a transplant from Jul '05 - Dec '07.

Waitlist Mortality
Lower Value = Better Performance

Details

Why is This Measure Important?

This is a measure of the number of patients who died while waiting for a transplant. The results for this measure may be influenced by the characteristics of the patients on the waitlist and availability of organs from suitable donors. The actual waitlist mortality rate for the University of Michigan Health System is compared to the expected rate for our institution calculated by the U.S. Scientific Registry for Transplant Recipients (SRTR). Although the SRTR expected rates are adjusted to account for the severity of illness of our waitlisted patients, the adjustment is not perfect. In this graph, a percentage that is lower than the SRTR expected rate means better performance.

(Note: The rate accounts for the amount of time patients are waitlisted and is expressed as the number of deaths per 1,000 patient years on the waiting list.)

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How is UMHS Performing?

The University of Michigan Health System waitlist mortality has declined and fallen below the expected rate based on national experience. However, the difference between actual and expected rates is not statistically significant.

UMHS Source: Hospital Organ Transplant Information System.
Comparison Group Source: Scientific Registry of Transplant Recipients (SRTR).