OPTN/SRTR 2013 Annual Data Report: heart

Area of Science:

• Cardiology
• Transplant Surgery
• Public Health

Background:

• The number of heart transplants is increasing, but the waitlist for adult candidates grew by 34.2% between 2003 and 2013.
• The heart transplant rate per active adult candidate declined from a peak of 149.0 in 2007 to 87.4 in 2013.
• While waiting times have increased, waitlist mortality has not shown a corresponding rise.

Purpose of the Study:

• To analyze trends in heart transplantation, including waitlist dynamics, patient acuity, and outcomes.
• To examine changes in the pediatric heart transplant landscape and recipient survival rates.
• To understand the financial coverage of heart transplant recipients by Medicare.

Main Methods:

• Analysis of national data on heart transplant candidates, procedures, and survival rates.
• Examination of trends in waitlist size, transplant rates, and patient acuity over a decade (2003-2013).
• Review of Medicare payment data for heart transplant recipients.

Main Results:

• The proportion of patients on life support before heart transplantation increased significantly from 53.4% in 2008 to 65.8% in 2013.
• Medical urgency categories have become less distinct, with a majority of patients now in higher acuity levels.
• Annual pediatric heart transplants increased from 293 in 2003 to 411 in 2013, with improving 5-year survival rates (70%-80%) for transplants performed between 2001-2008.

Conclusions:

• Despite increased waiting times and higher patient acuity, heart transplant outcomes remain stable or are improving, particularly for pediatric recipients.
• The evolving landscape of heart transplantation necessitates continuous monitoring of waitlist management and patient outcomes.
• Medicare plays a substantial role in covering the costs associated with heart transplantation.