Lung transplant patients in Birmingham are facing significantly worse survival rates as a “sobering” report has revealed two-thirds of patients have died within five years, The Independent has learned.
Survival rates for lung transplant patients at University Hospitals Birmingham Foundation Trust after five years are now almost 20 percentage points lower than the other main hospitals specialising in lung transplants.
The latest figures from NHS Blood and Transplant have revealed Birmingham’s five-year survival rates decreased from 79 per cent in 2015-16 to 31 per cent in 2020-21, and have consistently been the lowest compared to the other four other transplant hospitals in Newscastle, Cambridgeshire, London and Manchester.
The latest NHSBT’s report showed of those patients who had a transplant in Birmingham between 2012 to 2016, 31 per cent survived. During the same period in Newcastle 47 per cent of patients survived, in Papworth and Manchester 51 per cent, while London’s Royal Harefield recorded a 56 per cent survival rate.
Birmingham recorded the lowest patient survival rates 90 days after surgery and for one year after surgery between 2016-17 to 2020-21. Although for these measures the hospital was within the national average, unlike its five-year survival rates.
NHS Blood and Transplant also revealed lung transplant rates nationally have been significantly hit during the pandemic. The number carried out in 2020-21 dropped by 44 per cent compared to 2019-20, from 156 to just 87. This is the biggest drop on record.
Experts also reported specific concerns over the transplant services in Birmingham in June this year, commenting they were at a “critical” level owing to a “severe” staff shortage within its critical care units.
Ten transplant patients had to be moved elsewhere, according to meeting minutes for the expert advisory group, which added: “Lung transplantation will be reassessed in 4 weeks’ time. It has been agreed that if there is a risk of not being able to go through with a procedure at short notice, backing up of offers going to Birmingham will be considered to avoid late declines.”
One transplant surgeon has raised concerns over the continued poor survival rates at Birmingham, claiming they showed the “staggering” failure for the programme in the city to improve.
The survival of patients from after they have been put on the waiting list for a transplant are also much lower within Birmingham, at 32 per cent for those on the list between 2009 and 2020.
A spokesperson for UHB told The Independent said: “Current 5-year survival outcomes reflect the 2012-16 period and it will take some further time yet for those improved 90 and one year mortality rates to be reflected in the 5 year survival rates.”
In 2016 the trust’s cardiac surgery department, which also carries out lung and heart transplants, was heavily criticised for ignoring repeated warnings over poor heart surgery outcomes.
Commenting on the figures, one external transplant consultant told The Independent the survival figures in Birmingham were “sobering.”
Speaking anonymously, they said with a 31 per cent rate of survival “you need to question whether there is any benefit of having that service. It has been a staggering feature of the Birmingham programme that for over a decade, despite enquiries, their lung transplant programme, in particular results have not improved, and their outcomes are possibly no better than not having the transplant.”
They added lung transplant surgery is a “massive and costly” operation with some patients spending months in intensive care with all the “difficulties patients in such facilities have to contend with”.
“In Birmingham, there are actually relatively few patients actually benefitting from it. The five-year survival rate is a real key marker of success of any programme,” the transplant consultant said.
According to standards set by the NHS for specialist heart and lung transplant services, there should not be “significant variation” from the national average for survival rates. Centres should also be carrying out around 25 lung transplants per year, according to NHS England standards. The only hospital to achieve this level of transplants during 2020-21 was Harefield hospital in London.
The last time services in Birmingham met this requirement was 2015-16 and it is the only hospital to have consistently carried out less than 25 operations during the last five years.
NHS England, as the commissioner of the service, was approached for comment on the low survival rates in Birmingham but it declined to comment.
NHS Blood and Transplant said it monitors centres each month and sends a letter directly to the centres if mortality rates are flagged as an issue. Commissioners of the service, in this case NHS England, are also informed of any concerns around a centres performance, NHSBT confirmed.
