Zurich’s cantonal government has rejected a plan which would have excluded it from carrying out top-level surgery.
Also on Friday the canton’s health director announced she was lifting a moratorium imposed on heart transplants at Zurich University Hospital following the death of a patient.
Last month the health directors of Switzerland’s 26 cantons agreed to restrict transplant operations after a criminal investigation was launched into a bungled heart transplant procedure at Zurich University Hospital.
Under the new arrangement, transplants would have been carried out in Basel, Bern and Lausanne, but not in Zurich.
Zurich health director Verena Diener told journalists she could not accept the plan as it stood and called for fresh discussions.
"We reject the intercantonal convention on the coordination and concentration of top-level surgery in its current form," she said.
For the agreement to come into effect at least 17 cantons, and all the cantons with universities, had to agree to it. Zurich’s refusal means that the accord cannot now be enforced.
The conference of cantonal health directors said it regretted canton Zurich’s decision, but that the accord was not yet dead.
The canton Bern health director and the Bern Insel Hospital – which carries out transplants - also reacted angrily, saying the decision did not make sense.
Diener announced that Zurich University Hospital would resume heart transplants with immediate effect.
She said the decision had been taken to coincide with the appointment of a new clinic director. Michele Genoni takes up his post on August 1.
Genoni replaces Marko Turina, the surgeon in charge of an ill-fated operation last year. The patient, Rosmarie Voser, died shortly after being given a new heart that was incompatible with her blood group.
A criminal investigation is looking at how Voser came to be given the wrong heart. It has been alleged that surgeons involved in the operation deliberately chose to transplant an organ of the wrong blood group.
The transplant moratorium was ordered by the Zurich cantonal health director on June 19 to protect staff and patients while the investigations continued.
swissinfo with agencies
The intercantonal agreement was aimed at coordinating top-level surgery, with a smaller number of centres carrying out transplant operations.
It was aimed at saving money and making treatment more efficient.
The moratorium on transplants at Zurich University Hospital was imposed on June 19 amid investigations into the death of a patient given a heart of the wrong blood type.