MGH Prohibits Transplant of Human Hearts

The Massachusetts General Hospital (MGH) Board of Trustees decided last week that the institutions will not perform heart transplants because the operations would divert too large a proportion of resources to a limited number of patients.

"Over 1000 open-heart surgery operations a year are performed a year at MGH, "Martin S. Bander, Deputy to the General Director of MGH, said yesterday.

"One estimate is that eight routine operations would have to be given up in order to perform one transplant," he added.

Many Harvard Medical School professors said yesterday that they agree with the MGH decision.

John J. Collins, professor of surgery at Peter Bent Brigham, a Harvard teaching hospital, said yesterday the problem stems from the tremendous amount of time heart transplant patients must remain hospitalized. Since hearts, unlike kidneys, may only be taken from donors who are irreversibly ill or who have died recently, patients requiring such operations must sometimes wait weeks.

"When you add this to the six- or eight-week recuperation period, you see that transplant patients often spend ten to 12 weeks in the hospital-an awful lot of which is in the intensive care unit," Collins said, adding, "The Average ICU stay of a cardiac patient is 48 hours."

Furthermore, Collins said, hospitals are limited by law as to the number of beds which may be designated an ICU area. Even if a hospital had the money to expand its facilities to perform the operations, it would be unable to do so, he added.

Bernard Lown, professor of Cardiology in the Faculty of Public Health and an associate of MGH, said yesterday, "Heart disease causes 700,000 deaths in this country with transplants being the solution in only a miniscule number of cases," he said, adding, "It is not a major social issue. At the same time it extracts a major social cost."

The decision came after ten months of debate and a nearly unanimous decision by the hospital's General executive Committee, its medical leadership, to approve a proposal to perform six transplant operations each year. W. Gerald Austen, MGH Chief of Surgery, refused to comment on the issue.

Currently fewer than 40 heart transplant operations per year are performed in this country, most of them at Stanford University Medical Center.

Edgar Haber, professor of Medicine and an associate of MGH, said that an increase in the availability of hearts, a method of overcoming organ rejection and better mechanical ways for keeping people alive while they wait for hearts could lead to a reversal of the decision