Heart transplantation in the Netherlands

We have read with great interest the recent article by Sammani et al. and the accompanying editorial by Y. Pinto in the Netherlands Heart Journal [1, 2]. Evidently, the current level of care for heart transplantation recipients in the Netherlands is high, as presented by the authors. Reasons for improved survival rates are the introduction of better immunosuppressive therapies and the improvement of transplantation care and follow-up. Heart transplant survival has improved over time, despite a change in clinical characteristics such as increased donor age and more frequent use of left ventricular assist devices in recipients. Over the last 30 years the organisation of care for heart transplant patients in the Netherlands has changed as well. In the 1980s, heart transplantation care was limited to two centres, i. e. Utrecht and Rotterdam, but part of the followup care (after the actual transplantation in Utrecht) of patients living in the northern and eastern parts of the country was provided at the University Medical Center in Groningen (UMCG) as early as 1991. Indeed, some of the results presented by the authors of the Utrecht programme should thus be regarded as a multicentre and national achievement. The UMCG has been established as an independent heart transplantation centre since 2007 and is responsible for the complete programme, including screening, transplantation and postoperative treatment of these patients in Groningen. The overall expertise in organ transplantation in the