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Editor - Westaby and Poole-Wilson(1) insist that clinical trials,
rather than observational studies alone, must be done before left
ventricular assist devices are absorbed into the health service as
treatment for otherwise intractable cardiac failure.
No such trials were carried out before the adoption of cardiac
transplantation as a standard therapeutic option for that purpose -
leaving that procedure open to the challenge that, taking all relevant
considerations into account, it has done more harm than good.
While the clinical problems, and the resource and financial
implications, merited rigorous objective assessment which was sadly
lacking, for those of us who believed it wrong to take hearts for
transplantation from patients who were not really, but only notionally,
dead that was the paramount objection. That remains the case today.
1. Westaby S, Poole-Wilson P. Mechanical circulatory support in the
UK - It is time to do a trial of left ventricular assist devices for
lifetime use. BMJ (27 January) 2007;334:167-8
Competing interests:
I resigned my post as Consultant Cardiologist at Papworth Hospital in 1988 in order to protest against cardiac transplantation
Heart transplants
Editor - Westaby and Poole-Wilson(1) insist that clinical trials,
rather than observational studies alone, must be done before left
ventricular assist devices are absorbed into the health service as
treatment for otherwise intractable cardiac failure.
No such trials were carried out before the adoption of cardiac
transplantation as a standard therapeutic option for that purpose -
leaving that procedure open to the challenge that, taking all relevant
considerations into account, it has done more harm than good.
While the clinical problems, and the resource and financial
implications, merited rigorous objective assessment which was sadly
lacking, for those of us who believed it wrong to take hearts for
transplantation from patients who were not really, but only notionally,
dead that was the paramount objection. That remains the case today.
1. Westaby S, Poole-Wilson P. Mechanical circulatory support in the
UK - It is time to do a trial of left ventricular assist devices for
lifetime use. BMJ (27 January) 2007;334:167-8
Competing interests:
I resigned my post as Consultant Cardiologist at Papworth Hospital in 1988 in order to protest against cardiac transplantation
Competing interests: No competing interests