Call for fewer heart transplant units
The number of adult heart transplant units in the UK should be cut because too few transplants are being performed, heart experts say.
Doctors at Newcastle's Freeman Hospital said it was time to rethink the need for six centres after a 46% fall in transplants in the last decade.
They said having bigger and better resourced units may be preferable, the British Medical Journal reported.
The government has already indicated it is looking to carry out a review.
It is unclear why the number of heart transplants has fallen as the number of potential donors is at a record high.
A decade ago, 159 transplants were carried out each year, but by 2009-10 that had fallen to 86, the researchers said.
The analysis by four doctors, including two surgeons, suggested it could be down to a lack of intensive care beds or it could be because potential donors are found to have hearts which are unsuitable for transplant.
The fall in transplants has meant doctors are having to increasingly rely on the use of mechanical heart pumps instead.
But the experts said it was now important to review whether the right patients were being prioritised for transplants as well as looking whether the six units - in Birmingham, Glasgow, Newcastle, Manchester, Cambridge and London - were still viable.
One of the risks of having smaller centres is that surgeons do not do enough transplants to maintain their skills - although there are no suggestions care is suffering yet.
Professor Peter Weissberg, medical director at the British Heart Foundation, conceded fewer centres may be the solution.
But he added he would like to see more work to increase the number of suitable donors.
"Encouraging more people to join the organ donor register, or even better, changing our organ donation system so people must 'opt out' if they don't want to donate would help increase the number of donor hearts available."
NHS medical director Sir Bruce Keogh said an official review would be starting soon to ensure transplants were being "carried out in the most effective way".
He added: "The department is committed to strengthening the heart transplant programme, increasing the number of organ donors and hearts donated for transplant and giving more people the opportunity to benefit from a heart transplant."