Abstract 4147096: Heart Transplantation Trends and Associated Costs: A 12-year Retrospective Analysis on Nationwide Readmission Database (2010-2021)

Introduction: Increased prevalence and incidence of heart failure have resulted in a significant rise in the number of patients progressing to advanced heart failure (AHF). Heart transplantation (HT) has been the gold standard treatment for AHF. However, there is limited long-term data on trends in HT procedures and associated costs. Aim: This study aims to perform a comprehensive analysis to ascertain the trends in the number of HTs and the corresponding costs incurred. Methods: Utilizing the National Readmission Database 2010 to 2021, the study population was identified as new recipients of HT, and their median index admission charges were evaluated. We excluded patients aged < 18 with HT and LVAD during the index hospitalization. Results: We identified 36,379 weighted index hospital admissions from January to December 2010 - 2021. The annual HTs increased from 2,905 to 4,046, and the HT numbers increased by 39.28% (Figure 1). From 2010 to 2017, the HT numbers increased by approximately 11.46%; from 2018 to 2021, the increase was about 19.81%. Concurrently, median index admission costs increased from $146,817 in 2010 to $243,079 in 2021 (Figure 2), with a 65.57% cost increase. Considering patient demographics, 47% had private insurance, and Medicare covered 34%. Most patients were discharged home (48%) or to home with health care services (42%). Conclusion: Over the past 12 years, the total number of HT procedures rose by 39.28%. However, associated costs have surged disproportionately by 65.57% since 2010. A significant increase in OHT procedures from 2018 may be linked to policy changes by the United Network for Organ Sharing(Maitra, Dugger et al., 2023). Escalating costs warrant in-depth evaluation and potential policy revisions to curb healthcare expenses for managing advanced end-stage heart failure.