[Regional differences in referral for heart transplantation]

Area of Science:

• Cardiology
• Transplantation Medicine
• Public Health

Context:

• Cardiac transplantation is a vital treatment for end-stage heart disease, yet access is limited.
• Significant regional disparities exist in patient referrals for cardiac transplantation within German-speaking Switzerland.

Purpose:

• To investigate referral frequencies and transplantation rates across different Swiss regions.
• To assess the impact of geographical origin on patient prognosis after cardiac transplantation.

Summary:

• A study of 401 patients (1989-1995) revealed unequal referral rates for cardiac transplantation, with higher rates from southeastern Switzerland.
• While transplant frequency was uniform, survival rates for non-transplanted patients varied regionally, correlating with referral rates and specialized follow-up.
• Increased transplantation activity in specific years reduced waiting list mortality and shortened transplant times.

Impact:

• Regional disparities in cardiac transplantation referrals highlight access inequalities.
• Early consideration of transplantation and specialized follow-up in heart failure clinics improve patient outcomes.
• Donor recruitment remains a critical challenge in expanding cardiac transplantation programs.