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Published on: June 10, 2025
Trends in Heart Transplantation and Outcome Analysis: Nationwide Study Using the National Inpatient Sample and
Vivek Joseph Varughese1, Aditya Sunil Bhaskaran2, Hadrian Hoang-Vu Tran3
1Department of Internal Medicine, University of South Carolina, Prisma Health, 2 Med Park, Richland, WA 29203, USA.
Medical Sciences (Basel, Switzerland)
|May 23, 2025
Summary
Heart transplantation (Htx) increased from 2016-2022, but disparities persist. High 30-day readmission rates, particularly with peripheral vascular disease, require improved post-transplant care.
Area of Science:
- Cardiology
- Transplantation Medicine
- Health Services Research
Background:
- Heart transplantation (Htx) is the primary treatment for end-stage heart failure.
- Donor availability remains a critical limitation despite advances in mechanical support and immunosuppression.
- This study examines Htx trends, demographics, mortality, and readmissions in the U.S. from 2016-2022.
Purpose of the Study:
- To analyze trends in heart transplantation utilization in the United States.
- To investigate demographic shifts, mortality rates, and 30-day readmission patterns post-Htx.
- To identify factors associated with readmission and inform future care strategies.
Main Methods:
- Utilized the National Inpatient Sample (NIS) (2016-2022) and National Readmissions Database (NRD) (2021).
- Identified Htx admissions via ICD-10 PCS code O2YA0Z0.
- Analyzed patient characteristics, mortality, and readmissions using ANOVA and logistic regression.
Main Results:
- Htx procedures rose from 641 (2016) to 773 (2022); mean recipient age was 45-50.
- Persistent racial (60% White) and socioeconomic (21-26% lowest income quartile) disparities were observed.
- In-hospital mortality was stable (4-7%); 30-day readmission was 57.7% in 2021, with heart failure, rejection, and infection as primary causes. Peripheral vascular disease increased readmission risk (OR: 1.815).
Conclusions:
- Heart transplantation utilization has increased, linked to improved allocation and perioperative care.
- Significant racial and socioeconomic disparities in Htx persist.
- High readmission rates necessitate optimized post-transplant care and targeted interventions to address disparities and improve outcomes.
