As of December, over the nine-year lifetime of its program, Via Christie had performed 102 heart transplants and 93 percent of those patients had survived one year. The national average is 82 percent. Via Christie has the only heart transplant program in Kansas. Mo. Estep said attempts to limit the number of centers performing transplants should be based first on death rates, then on volume. But that debate has remained within the fraternity.
Few patients are aware that volume is a predictor of mortality, many doctors acknowledge.
Ill. Lupo, who is still working, has been on the waiting list for a heart transplant at Barnes Hospital in St. Louis since May 1995. Barnes is a high-volume center, averaging about 24 transplants a year. Because she has twice undergone open-heart surgery, Lupo is considered to be at a higher risk for death or complications resulting from a transplant. She now has a much longer drive, about three hours, to go for her quarterly tests, but that doesn't bother her. Lupo said she learned about the importance of volume when she sought a second opinion from a transplant cardiologist who was not involved in her care.