A leading heart transplant hospital has been told by inspectors it can resume operations after treatment was suspended following a rise in deaths.
Papworth alerted the authorities to a raised death rate
Cambridgeshire's Papworth Hospital alerted the government about the issue and agreed to stop operating while a watchdog investigated.
The Healthcare Commission ruled the quality of care was good.
It found there were no common factors to explain the rise in death rates following surgery.
But the inspectors said they would keep a close eye on future performance, and told the hospital it would have to tell patients about the mortality figures.
The hospital raised the alarm last month following the deaths of seven out of 20 patients treated this year who died within 30 days of surgery.
The 35% mortality rate compared with 7% in the previous two years.
An eighth patient has also died but this was beyond the key 30 day limit used to assess the success of surgery.
Nigel Ellis, the Healthcare Commission's head of investigations, praised the hospital for alerting the authorities.
He said it was not possible to categorically say the rise in deaths was just an anomaly.
But he added: "I want to be clear that we did not find any evidence of inadequate care, or that the deaths could have been prevented.
"The quality of care was generally of a high standard."
But he said the recommendations made should "reassure the public that everything possible was being done to protect patients".
The two-week investigation, which involved interviews with staff, statistical analysis, and evaluation of medical records, found that the patients who died tended to have a longer ischaemic time - the period the heart is without blood - from the removal of the organ to transplant.
The watchdog said this was a contributing factor, but that it was no different to other transplant centres.
Mr Ellis added: "The fact remains that heart transplantation is risky, and is carried out on extremely ill patients."
Inspectors also told the hospital to bring some of its pratices in line with other centres, but again Papworth was not directly criticised.
In particular, the way it transported hearts in ice and a technique used to protect them during surgery were cited.
Steven Tsui, the hospital's clinical director of transplant services, said: "There are certain clinical preferences even though there is a lot of information sharing between hospitals."
He said this was because there are such a low number of transplants in the UK each year that it was not always possible to deploy evidence-based practice.
And hospital chief executive Stephen Bridge described the transplant team as "highly professional and dedicated".
He added: "We welcomed the report and embrace all its recommendations."