Proposals to shift heart and lung services from the famous Harefield Hospital to a £300m development in west London's Paddington basin went to public consultation today.
The plans would create a new site next to St Mary's Hospital, which would lose its specialist renal services to Hammersmith Hospital.
Specialist children's services - currently provided at St Mary's, Chelsea & Westminster Hospital, Hammersmith Hospital, the Royal Brompton Hospital and Harefield Hospital - would be concentrated on one site at St Mary's.
Leading the proposals, Kensington, Chelsea & Westminster health authority said the changes were driven by clinical evidence backing large specialist centres.
In the past year, renal services at St Mary's have carried out 47 transplants, and services at Hammersmith have carried out 21. Bringing the two centres together would bring the total number closer to recommendations from the Royal College of Surgeons that a minimum of 75 transplants per year should be carried out by any centre.
Modernising Specialist Acute Hospital Services in West London: public consultation document. www.wlhas.org.uk