Heart transplant director warned air support deficiency put patients at risk

Insufficient air support for organ transport has put patients at risk of missing out on heart transplants, the Director of the National Heart/Lung Transplant Programme warned in correspondence to the HSE in August and September 2018, seen by the Medical Independent under Freedom of Information law.

On 26 September, Mr Lars Nolke informed the Director of HSE Organ Donation and Transplant Ireland (ODTI) Prof Jim Egan, “we are vulnerable in terms of access to air support for heart retrieval and there is a possibility that a heart transplant may have to be cancelled because of no air transport”.

In correspondence to Prof Egan, dated 29 August, Mr Nolke said air support put in place for patients travelling to the UK for transplants was potentially available for organ transport in Ireland. However, this “could be pulled at any time if a transplant were to happen in the UK for an Irish patient”. A meeting had taken place with the HSE, where it was agreed to develop a plan for hospitals requiring air support, wrote Mr Nolke.

He was responding to correspondence from Prof Egan, who requested feedback regarding a meeting on these issues between the Mater Misericordiae University Hospital and HSE National Ambulance Service. 

Last week, a Mater spokesperson said air support was accessed via the HSE. The Mater used private transport when the service was not available and this had increased in the past year. The spokesperson added that other “solutions” were being examined.

The process for transport of heart donations was discussed “under an adverse event” at the National Organ Donation and Transplant Advisory Group, Prof Egan informed the Chair of the National Aeromedical Co-ordination Group (NACG) Dr Cathal O’Donnell on 26 June. 

Prof Egan referred to a lack of structure regarding “consistency of availability of transport” and how this is funded. He advised that Dr O’Donnell host a meeting to address this issue with stakeholders. Among those cc-ed was Ms Angela Fitzgerald, currently interim head of HSE acute services.

On 27 July, Dr O’Donnell advised that the NACG oversaw transplant patient transfers and not that of organs.

In May, in a reply to ODTI, Dr O’Donnell said availability of the Air Corps and Coast Guard had “reduced significantly in recent times” and access had always been on an “as-available basis”.