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Economics

OPTN/SRTR 2016 Annual Data Report: Economics

Abstract

Medicare costs vary for solid organ transplant recipients by outcome: survival with graft function, survival with graft failure, and death. Average per-person per-year reimbursement was $75 thousand for kidney recipients who survived the first year posttransplant with a functioning graft, $171 thousand for those who required a return to dialysis or retransplant, and $350 thousand for those who died with function. For pancreas recipients: $105 thousand for those who survived the first year with a functioning graft, $120 thousand for those who survived pancreas failure, and $443 thousand for those who died with function. For liver recipients: $154 thousand for those who survived with a functioning graft, $388 thousand for those who required retransplant, and $740 thousand who died with function. For intestine recipients: $301 thousand for those who survived with a functioning graft and $1 million for those who died with function. For heart recipients: $272 thousand for those who survived with a functioning graft and $1.2 million for those who died with function. For lung recipients: $196 thousand for those who survived with a functioning graft, $642 thousand for those who required retransplant, and $761 thousand for those who died with function.

Introduction

SRTR continues to release new data for use in cost-effectiveness modeling and health economics and financial analysis in solid organ transplantation with this Annual Data Report. The cost impact of posttransplant outcomes is the subject of this year’s data expansion. Costs for recipients who survive with graft function, survive with graft failure, or die are presented separately for the first time. Future reports will continue to present these expanded data by outcome and we expect to present pretransplant costs separately for patients who do not undergo transplant separated by reason.

Kidney

From transplant through the first year posttransplant, the average reimbursement for kidney recipients with primary Medicare coverage at the time of transplant in 2008-2013 was $82 thousand (Table Econ 2). Average per-person per-year (PPPY) reimbursement for recipients who survived the first year posttransplant with a functioning graft was $75 thousand. This rose to $171 thousand for those who survived but required a return to dialysis or retransplant, 229% of the cost for those who ended the year alive with function. Average PPPY reimbursement for recipients who died with function in the first year was $350 thousand, 469% of the cost for those who ended the year alive with function. Average PPPY reimbursement for recipients who experienced graft failure and subsequently died was $506 thousand, 679% of the cost for those who ended the year alive with function. Patterns were similar in the second posttransplant year (Table Econ 3); however, relative costs were higher for recipients who died and/or experienced graft failure. Relative to $22 thousand average PPPY expenditure for recipients who were alive with function at the end of the second year, $84 thousand (389%) was spent on recipients who required a return to dialysis or retransplant, $84 thousand PPPY (589%) on those who died with function, and $201 thousand PPPY on those who died following graft failure.

Total Medicare reimbursement during the first year posttransplant was $4.6 billion (Table Econ 2). Of this, expenditures by outcome were $4.0 billion (86%) for recipients alive with a functioning graft, $321 million (6.9%) for those who survived but required a return to dialysis or retransplant, $246 million (5.3%) for those who died with function, and $81 million (1.7%) for those who died following graft failure. Proportions were: 93% of recipients alive with a functioning graft, 3.3% survived but required a return to dialysis or retransplant, 3.2% died with function, and 0.6% died following graft failure. Overall, the 7.1% of recipients who experienced death and/or graft failure within the first year posttransplant accounted for 14% of total costs. In contrast, the 7.7% of recipients who experienced death and/or graft failure within the second year posttransplant accounted for 24% of total costs (Table Econ 3). This was due primarily to increased proportions returning to dialysis or undergoing retransplant in the second year combined with their greater relative cost, thus accounting for 17% of total Medicare reimbursement in the second year.

Total Medicare expenditures in 2013 and 2014 for all kidney transplant recipients with graft function at the beginning of the year are presented in Table Econ 4 and Table Econ 5. Recipients with Medicare primary and/or secondary coverage are included in these tables if Medicare made any reimbursement for their care within the calendar year. Average PPPY and total Medicare reimbursement were $32 thousand and $4.1 billion in 2013 and $33 thousand and $4.2 billion in 2014. In each year, 2013 and 2014, 8.2% if recipients died and/or experienced graft failure, accounting for 17% of Medicare reimbursements. Compared with recipients in the second year posttransplant (Table Econ 3), PPPY costs averaged over 2013 and 2014 were 33% higher for those alive with function, 20% lower for those who required a return to dialysis or retransplant, 1% lower for those who died with function, and 18% lower for those who experienced graft failure followed by death.

Pancreas

From transplant through the first year posttransplant, the average reimbursement for pancreas recipients with primary Medicare coverage at the time of transplant in 2008-2013 was $110 thousand (Table Econ 7). Average per-person per-year (PPPY) reimbursement for recipients who survived the first year posttransplant with a functioning graft was $105 thousand. This rose to $120 thousand for recipients who survived pancreas failure, 115% of the cost for those who ended the year alive with graft function. Average PPPY reimbursement for recipients who died with function in the first year was $443 thousand, 423% of the cost for those who ended the year alive with function. Average per-patient costs in the second year posttransplant were $32 thousand, 35% less than the $49 thousand average cost in the year preceding transplant. Costs by outcome were much less in the second year posttransplant (Table Econ 8); however, relative costs were higher for recipients who died and/or experienced graft failure. Relative to $30 thousand average PPPY expenditure for recipients who were alive with function at the end of the second year, $59 thousand PPPY (195%) was spent on those who experienced pancreas failure, and $191 thousand PPPY (636%) on those who died with function.

Total Medicare reimbursement during the first year posttransplant was $318 million (Table Econ 7). Of this, expenditures by outcome were $270 million (85%) for recipients alive with a functioning graft, $32 million (10%) for those who survived pancreas failure, and $15 million (4.8%) for those who died with function. Proportions were: 87% of recipients alive with a functioning graft, 10% survived graft failure, and 3.0% died with function. Overall, the 13% of recipients who died and/or experienced graft failure within the first year posttransplant accounted for 15% of total costs. The 4.9% of recipients who died and/or experienced graft failure within the second year posttransplant accounted for 11% of total costs (Table Econ 8). Death with function accounted for 4.4% of costs, but only 1.4% of recipients, due to their relatively high cost.

Total Medicare expenditures in 2013 and 2014 for all pancreas transplant recipients with graft function at the beginning of the year for whom Medicare made any payment during the year are presented in Table Econ 9 and Table Econ 10. Average PPPY and total Medicare reimbursement were $32 thousand and $312 million in 2013 and $33 thousand and $322 million in 2014. In 2013, 6.4% of recipients died or and/or experienced graft failure, and 7.0% in 2014; these recipients accounted for 14% of Medicare reimbursement in 2013 and 15% in 2014. Compared with recipients in the second year posttransplant (Table Econ 8), PPPY costs averaged over 2013 and 2014 were 2.9% lower for those alive with function, 17% higher for those experiencing graft failure, and 31% lower for those who died with function.

Liver

From transplant through the first year posttransplant, the average reimbursement for liver recipients with primary Medicare coverage at the time of transplant in 2008-2013 was $185 thousand (Table Econ 12). Average per-person per-year (PPPY) reimbursement for recipients who survived the first year posttransplant with a functioning graft was $154 thousand. This rose to $388 thousand for recipients who required retransplant, 252% of the cost for those who ended the year alive with function. Average PPPY reimbursement for recipients who died with function in the first year was $740 thousand, 479% of the cost for those who ended the year alive with function. Costs were considerably less in the second year posttransplant (Table Econ 13). Average per-patient costs in the second year posttransplant were $28 thousand, 44% less than the $50 thousand average cost in the year preceding transplant. Relative to $25 thousand average PPPY expenditure for recipients who were alive with function at the end of the second year, $123 thousand (491%) was spent for those who required retransplant and $145 thousand (579%) for those who died with function.

Total Medicare reimbursement during the first year posttransplant was $1.2 billion (Table Econ 12). Of this, expenditures by outcome were $926 million (78%) for recipients who were alive with a functioning graft, $48 million (4.0%) for those who required retransplant, and $209 million (18%) for those who died with function. Proportions were: 86% alive with a functioning graft, 2.1% required retransplant, and 12% died with function. Overall, the 14% of recipients who died and/or experienced graft failure within the first posttransplant year accounted for 22% of total costs. The 6.2% of recipients who died and/or required retransplant within the second posttransplant year accounted for 16% of total costs (Table Econ 13).

Total Medicare expenditures in 2013 and 2014 for all liver transplant recipients with graft function at the beginning of the year are presented in Table Econ 14 and Table Econ 15. Recipients with Medicare primary and/or secondary coverage are included in these tables if Medicare made any reimbursement for their care within the calendar year. Average PPPY and total Medicare reimbursement were $26 thousand and $709 million in 2013 and $26 thousand and $739 million in 2014. In 2013, 6.9% of recipients died and/or required retransplant, accounting for 18% of Medicare reimbursement; in 2014 and 7.0% of such recipients accounted for 18% of Medicare reimbursement. Compared with recipients in the second year posttransplant (Table Econ 13), PPPY costs averaged over 2013 and 2014 were 11% lower for those alive with function, 61% higher for those who required retransplant, and 16% lower for those who died. Costs associated with retransplant in 2013 and 2014 averaged $197 thousand PPPY, 107% of costs for first transplant recipients between 2008 and 2013.

Intestine

From transplant through the first year posttransplant, the average per-person per-year (PPPY) reimbursement for intestine recipients with primary Medicare coverage at the time of transplant in 2008-2013 was $366 thousand and total reimbursement was $22 million (Table Econ 17). Average PPPY Medicare reimbursement was $301 thousand and total cost $15 million for the 70% of recipients who survived the first year posttransplant with a functioning graft. Average PPPY reimbursement rose to $1 million for recipients who died with function in the first year, 345% of the cost for those who ended the year alive with function, accounting for $5.8 million in total cost. Average per-patient costs in the second year posttransplant were $94 thousand, 28% less than the $130 thousand average cost in the year preceding transplant. Average PPPY cost in the second year posttransplant was $105 thousand and total cost was $4.1 million (Table Econ 18). Average cost was $88 thousand for recipients who survived the second year posttransplant, 84% of the average of all recipients.

Total Medicare expenditures in 2013 and 2014 for all Medicare-covered (primary or secondary) intestine transplant recipients with graft function at the beginning of the year are presented in Table Econ 19 and Table Econ 20. Average PPPY and total Medicare reimbursement were $60 thousand and $15 million in 2013 and $59 thousand and $15 million in 2014. In 2013, 13% of recipients died and/or experienced graft failure, accounting for 30% of Medicare reimbursement; in 2014, 15% of such recipients accounted for 31% of Medicare reimbursement. Compared with recipients in the second year posttransplant (Table Econ 18), PPPY costs averaged over 2013 and 2014 were 49% lower for those alive with function. Average PPPY Medicare reimbursement for recipients who died with function in 2013 or 2014 was $181 thousand.

Heart

From transplant through the first year posttransplant, the average per-person per-year (PPPY) reimbursement for heart recipients with primary Medicare coverage at the time of transplant in 2008-2013 was $305 thousand, and total reimbursement was $875 million (Table Econ 22). Average PPPY Medicare reimbursement was $272 thousand and total cost $753 million for the 88% of recipients who survived the first year posttransplant with a functioning graft. Average PPPY reimbursement rose to $1.2 million for recipients who died with function in the first year, 449% of the cost for those who ended the year alive with function and accounting for $122 million in total cost. Average PPPY cost in the second year posttransplant was $36 thousand and total cost was $78 million (Table Econ 23). Ninety-five percent of recipients survived the second year posttransplant with function, with an average PPPY cost of $32 thousand, 90% of the average of all recipients. Average per-patient costs in the second year posttransplant were $35 thousand, 69% less than the $112 thousand average cost in the year preceding transplant. During the second year posttransplant, 4.4% of recipients died with function at an average PPPY cost of $157 thousand and total cost of $7.1 million, 9.1% of total costs across all recipients.

Total Medicare expenditures in 2013 and 2014 for all Medicare-covered heart transplant recipients with graft function at the beginning of the year are presented in Table Econ 24 and Table Econ 25. Average and total Medicare reimbursement was $36 thousand and $464 million in 2013 and $37 thousand and $485 million in 2014. In 2013, 7.3% of recipients died and/or experienced graft failure, accounting for 15% of Medicare reimbursement; in 2014, and 7.7% of such recipients accounted for 16% of Medicare reimbursement.

Lung

From transplant through the first year posttransplant, the average per-person per-year (PPPY) reimbursement for lung recipients with primary Medicare coverage at the time of transplant in 2008-2013 was $239 thousand (Table Econ 27). Average PPPY reimbursement for recipients who survived the first year posttransplant with a functioning graft was $196 thousand. This rose to $642 thousand for recipients who required retransplant, 328% of the cost for those who ended the year alive with function. Average PPPY reimbursement for recipients who died with function in the first year was $761 thousand, 389% of the cost for those who ended the year alive with function. Costs were considerably less in the second year posttransplant (Table Econ 28). Average per-patient costs in the second year posttransplant were $49 thousand, 61% more than the $32 thousand average cost in the year preceding transplant. Relative to $41 thousand average PPPY expenditure for recipients who were alive with function at the end of the second year, $261 thousand PPPY (644%) was spent on those who required retransplant and $197 thousand PPPY (484%) on those who died with function.

Total Medicare reimbursement during the first year posttransplant for lung recipients was $674 million (Table Econ 27). Of this, expenditures by outcome were $510 million (76%) for those alive with a functioning graft, $20 million (3.0%) for those who required retransplant, and $145 million (21%) for those who died with function. Proportions were: 83% of recipients alive with a functioning graft, 1.7% required retransplant, and 15% died with function. Overall, the 17% of recipients died and/or experienced graft failure within the first year posttransplant, accounting for 24% of total costs. The 12% of recipients who died and/or required retransplant within the second year posttransplant accounted for 27% of total costs (Table Econ 28).

Total Medicare expenditures in 2013 and 2014 for all lung transplant recipients with graft function at the beginning of the year are presented in Table Econ 29 and Table Econ 30. Recipients with primary or secondary Medicare coverage are included in these tables if Medicare made at least one payment for their care within the calendar year. Average PPPY and total Medicare reimbursement were $49 thousand and $301 million in 2013 and $48 thousand and $309 million in 2014. In 2013, 12% of recipients died and/or required retransplant, accounting for 24% of Medicare reimbursement; in 2014, and 12% of such recipients accounted for 23% of Medicare reimbursement.

Figure List

Kidney

Figure Econ 1. Medicare coverage among kidney transplant recipients, 2008-2014

Pancreas

Figure Econ 2. Medicare coverage among pancreas transplant recipients, 2008-2014

Liver

Figure Econ 3. Medicare coverage among liver transplant recipients, 2008-2014

Intestine

Figure Econ 4. Medicare coverage among intestine transplant recipients, 2008-2014

Heart

Figure Econ 5. Medicare coverage among heart transplant recipients, 2008-2014

Lung

Figure Econ 6. Medicare coverage among lung transplant recipients, 2008-2014

Table List

Kidney

Table Econ 1. Average per person per year Medicare costs of kidney transplant recipients during the year prior to transplant
Table Econ 2. Total and per person per year Medicare costs of kidney transplant recipients in year 1 posttransplant
Table Econ 3. Total and per person per year Medicare costs of kidney transplant recipients in year 2 posttransplant
Table Econ 4. Total and per person per year (PPPY) calendar-year Medicare costs of kidney transplant recipients, 2013
Table Econ 5. Total and per person per year (PPPY) calendar-year Medicare costs of kidney transplant recipients, 2014

Pancreas

Table Econ 6. Average per person per year Medicare costs of pancreas transplant recipients during the year prior to transplant
Table Econ 7. Total and per person per year Medicare costs of pancreas transplant recipients in year 1 posttransplant
Table Econ 8. Total and per person per year Medicare costs of pancreas transplant recipients in year 2 posttransplant
Table Econ 9. Total and per person per year (PPPY) calendar-year Medicare costs of pancreas transplant recipients, 2013
Table Econ 10. Total and per person per year (PPPY) calendar-year Medicare costs of pancreas transplant recipients, 2014

Liver

Table Econ 11. Average per person per year Medicare costs of liver transplant recipients during the year prior to transplant
Table Econ 12. Total and per person per year Medicare costs of liver transplant recipients in year 1 posttransplant
Table Econ 13. Total and per person per year Medicare costs of liver transplant recipients in year 2 posttransplant
Table Econ 14. Total and per person per year (PPPY) calendar-year Medicare costs of liver transplant recipients, 2013
Table Econ 15. Total and per person per year (PPPY) calendar-year Medicare costs of liver transplant recipients, 2014

Intestine

Table Econ 16. Average per person per year Medicare costs of intestinal transplant recipients during the year prior to transplant
Table Econ 17. Total and per person per year Medicare costs of intestine transplant recipients in year 1 posttransplant
Table Econ 18. Total and per person per year Medicare costs of intestine transplant recipients in year 2 posttransplant
Table Econ 19. Total and per person per year (PPPY) calendar-year Medicare costs of intestine transplant recipients, 2013
Table Econ 20. Total and per person per year (PPPY) calendar-year Medicare costs of intestine transplant recipients, 2014

Heart

Table Econ 21. Average per person per year Medicare costs of heart transplant recipients during the year prior to transplant
Table Econ 22. Total and per person per year Medicare costs among heart transplant recipients in year 1 posttransplant
Table Econ 23. Total and per person per year Medicare costs among heart transplant recipients in year 2 posttransplant
Table Econ 24. Total and per person per year (PPPY) calendar-year Medicare costs of heart transplant recipients, 2013
Table Econ 25. Total and per person per year (PPPY) calendar-year Medicare costs of heart transplant recipients, 2014

Lung

Table Econ 26. Average per person per year Medicare costs of lung transplant recipients during the year prior to transplant
Table Econ 27. Total and per person per year Medicare costs of lung transplant recipients in year 1 posttransplant
Table Econ 28. Total and per person per year Medicare costs of lung transplant recipients in year 2 posttransplant
Table Econ 29. Total and per person per year (PPPY) calendar-year Medicare costs of lung transplant recipients, 2013
Table Econ 30. Total and per person per year (PPPY) calendar-year Medicare costs of lung transplant recipients, 2014

A bar plot for medicare coverage among kidney transplant recipients, 2008-2014, the  less than 18 age group is 42.11 percent for no medicare, and 57.89 percent for any medicare; the 18 to 34 age group is 21.21 percent for no medicare, and 78.79 percent for any medicare; the 35 to 49 age group is 16.69 percent for no medicare, and 83.31 percent for any medicare; the 50 to 64 age group is 14.40 percent for no medicare, and 85.60 percent for any medicare; and the  greater than or equal to 65 age group is 1.82 percent for no medicare, and 98.18 percent for any medicare.

Figure Econ 1. Medicare coverage among kidney transplant recipients, 2008-2014
Coverage at the time of transplant as identified by the Medicare Beneficiary Annual Summary supplied by CMS.


A bar plot for medicare coverage among pancreas transplant recipients, 2008-2014, the  less than 18 age group is 98.26 percent for no medicare, and 1.74 percent for any medicare; the 18 to 34 age group is 23.50 percent for no medicare, and 76.50 percent for any medicare; the 35 to 49 age group is 20.09 percent for no medicare, and 79.91 percent for any medicare; the 50 to 64 age group is 22.79 percent for no medicare, and 77.21 percent for any medicare; and the  greater than or equal to 65 age group is 12.50 percent for no medicare, and 87.50 percent for any medicare.

Figure Econ 2. Medicare coverage among pancreas transplant recipients, 2008-2014
Coverage at the time of transplant as identified by the Medicare Beneficiary Annual Summary supplied by CMS.


A bar plot for medicare coverage among liver transplant recipients, 2008-2014, the  less than 18 age group is 98.53 percent for no medicare, and 1.47 percent for any medicare; the 18 to 34 age group is 84.59 percent for no medicare, and 15.41 percent for any medicare; the 35 to 49 age group is 76.10 percent for no medicare, and 23.90 percent for any medicare; the 50 to 64 age group is 68.86 percent for no medicare, and 31.14 percent for any medicare; and the  greater than or equal to 65 age group is 9.69 percent for no medicare, and 90.31 percent for any medicare.

Figure Econ 3. Medicare coverage among liver transplant recipients, 2008-2014
Coverage at the time of transplant as identified by the Medicare Beneficiary Annual Summary supplied by CMS.


A bar plot for medicare coverage among intestine transplant recipients, 2008-2014, the  less than 18 age group is 99.33 percent for no medicare, and 0.67 percent for any medicare; the 18 to 34 age group is 77.12 percent for no medicare, and 22.88 percent for any medicare; the 35 to 49 age group is 68.39 percent for no medicare, and 31.61 percent for any medicare; the 50 to 64 age group is 53.03 percent for no medicare, and 46.97 percent for any medicare; and the  greater than or equal to 65 age group is 15.38 percent for no medicare, and 84.62 percent for any medicare.

Figure Econ 4. Medicare coverage among intestine transplant recipients, 2008-2014
Coverage at the time of transplant as identified by the Medicare Beneficiary Annual Summary supplied by CMS.


A bar plot for medicare coverage among heart transplant recipients, 2008-2014, the  less than 18 age group is 99.89 percent for no medicare, and 0.11 percent for any medicare; the 18 to 34 age group is 81.62 percent for no medicare, and 18.38 percent for any medicare; the 35 to 49 age group is 63.28 percent for no medicare, and 36.72 percent for any medicare; the 50 to 64 age group is 56.25 percent for no medicare, and 43.75 percent for any medicare; and the  greater than or equal to 65 age group is 8.53 percent for no medicare, and 91.47 percent for any medicare.

Figure Econ 5. Medicare coverage among heart transplant recipients, 2008-2014
Coverage at the time of transplant as identified by the Medicare Beneficiary Annual Summary supplied by CMS.


A bar plot for medicare coverage among lung transplant recipients, 2008-2014, the  less than 18 age group is 100.00 percent for no medicare, and 0.00 percent for any medicare; the 18 to 34 age group is 67.78 percent for no medicare, and 32.22 percent for any medicare; the 35 to 49 age group is 57.26 percent for no medicare, and 42.74 percent for any medicare; the 50 to 64 age group is 57.63 percent for no medicare, and 42.37 percent for any medicare; and the  greater than or equal to 65 age group is 6.70 percent for no medicare, and 93.30 percent for any medicare.

Figure Econ 6. Medicare coverage among lung transplant recipients, 2008-2014
Coverage at the time of transplant as identified by the Medicare Beneficiary Annual Summary supplied by CMS.


Table Econ 1 Average per person per year Medicare costs of kidney transplant recipients during the year prior to transplant
Costs among recipients with Medicare as primary payer at the time of transplant, 2009-2014. Pretransplant costs exclude the transplant hospitalization. Per person per year (PPPY) costs in $ units. Values for cells with 9 or fewer recipients are suppressed. CKD, cystic kidney disease; GN, glomerulonephritis.
Subgroup Patients, N Pre-tx, 365 days Pre-tx,90 days Pre-tx, 30 days
All recipients 47,063 46,637 11,120 2861
Age: 0-11 527 59,886 15,290 3555
Age: 12-17 632 47,512 12,238 3216
Age: 18-34 5774 48,790 11,847 3050
Age: 35-49 12,570 47,804 11,373 2908
Age: 50-64 17,442 46,419 11,073 2872
Age: ≥65 10,118 43,587 10,184 2614
Sex: Male 28,641 46,784 11,121 2841
Sex: Female 18,422 46,406 11,119 2890
Race/ethnicity: White 21,827 44,365 10,776 2831
Race/ethnicity: Black 14,523 50,016 11,619 2953
Race/ethnicity: Hispanic 7469 47,785 11,358 2896
Race/ethnicity: Asian 2551 43,681 10,586 2522
Race/ethnicity: Other/unknown 693 45,923 10,937 2713
Diagnosis: Diabetes 14,384 50,402 11,710 3026
Diagnosis: Hypertension 12,119 45,055 10,414 2627
Diagnosis: GN 7734 42,552 10,258 2608
Diagnosis: CKD 4808 42,015 10,134 2522
Diagnosis: Other 8018 49,031 12,561 3363



Table Econ 2 Total and per person per year Medicare costs of kidney transplant recipients in year 1 posttransplant
Costs for recipients with Medicare as primary payer at the time of transplant, 2008-2013. Year-1 costs include the transplant hospitalization. Costs incurred after a transplant failure are excluded. Total costs are given in $1000 units and per person per year (PPPY) costs in $ units. Values for cells with 9 or fewer recipients are suppressed. CKD, cystic kidney disease; GF, graft failure; GN, glomerulonephritis.
Subgroup N Total ($1000) PPPY ($)
All recipients 57,279 4,626,193 82,470
Age: 0-11 660 72,065 109,673
Age: 12-17 812 71,751 88,309
Age: 18-34 7127 550,833 77,646
Age: 35-49 15,383 1,198,850 78,882
Age: 50-64 21,190 1,726,070 83,475
Age: ≥65 12,107 1,006,624 86,364
Sex: Male 34,951 2,808,280 82,080
Sex: Female 22,328 1,817,913 83,083
Race/ethnicity: White 26,723 2,141,587 81,987
Race/ethnicity: Black 17,591 1,500,212 87,036
Race/ethnicity: Hispanic 9004 692,786 78,199
Race/ethnicity: Asian 3113 230,388 75,485
Race/ethnicity: Other/unknown 848 61,219 74,127
Diagnosis: Diabetes 17,282 1,518,663 90,588
Diagnosis: Hypertension 14,838 1,141,946 78,594
Diagnosis: GN 9543 682,223 72,224
Diagnosis: CKD 5837 424,629 73,599
Diagnosis: Other 9779 858,732 89,587
Outcome: Alive with function 53,201 3,977,905 74,567
Outcome: Dialysis/retransplant 1879 321,296 170,526
Outcome: Death with function 1829 246,095 349,424
Outcome: GF then death 370 80,899 506,240



Table Econ 3 Total and per person per year Medicare costs of kidney transplant recipients in year 2 posttransplant
Costs for recipients with Medicare as primary payer at the time of transplant, 2008-2012. Year 2 is from day 366 to day 730 posttransplant. Costs incurred after transplant failure are excluded. Total costs are given in $1000 units and per person per year (PPPY) costs in $ units. Values for cells with 9 or fewer recipients are suppressed. CKD, cystic kidney disease; GF, graft failure; GN, glomerulonephritis.
Subgroup N Total ($1000) PPPY ($)
All recipients 44,646 1,166,728 26,401
Age: 0-11 534 15,865 29,628
Age: 12-17 680 24,426 35,882
Age: 18-34 5801 152,109 26,275
Age: 35-49 12,204 293,289 24,164
Age: 50-64 16,242 430,271 26,818
Age: ≥65 9185 250,768 27,844
Sex: Male 27,090 685,705 25,603
Sex: Female 17,556 481,022 27,627
Race/ethnicity: White 20,952 534,414 25,808
Race/ethnicity: Black 13,704 392,504 28,926
Race/ethnicity: Hispanic 6974 175,826 25,379
Race/ethnicity: Asian 2359 48,641 20,818
Race/ethnicity: Other/unknown 657 15,343 23,517
Diagnosis: Diabetes 13,170 415,973 32,031
Diagnosis: Hypertension 11,681 289,760 25,088
Diagnosis: GN 7556 164,035 21,844
Diagnosis: CKD 4550 99,034 21,893
Diagnosis: Other 7689 197,927 25,960
Outcome: Alive with function 41,196 891,110 21,572
Outcome: Dialysis/retransplant 2327 196,036 84,014
Outcome: Death with function 876 53,731 127,048
Outcome: GF then death 247 25,851 201,388



Table Econ 4 Total and per person per year (PPPY) calendar-year Medicare costs of kidney transplant recipients, 2013
Costs paid by Medicare in 2013 for recipients alive with graft function in 2013, regardless of Medicare eligibility at the time of transplant. Costs incurred after transplant failure are excluded. Total costs are given in $1000 units and per person per year (PPPY) costs in $ units. Values for cells with 9 or fewer recipients are suppressed. CKD, cystic kidney disease; GF, graft failure; GN, glomerulonephritis.
Subgroup N Total ($1000) PPPY ($)
All recipients 136,150 4,085,889 32,340
Age: 0-11 1623 69,469 45,743
Age: 12-17 2684 124,231 48,586
Age: 18-34 21,733 781,778 37,679
Age: 35-49 39,962 1,159,864 30,858
Age: 50-64 51,041 1,378,222 29,308
Age: ≥65 19,107 572,325 33,858
Sex: Male 81,332 2,401,387 31,915
Sex: Female 54,818 1,684,502 32,964
Race/ethnicity: White 74,186 2,023,595 29,341
Race/ethnicity: Black 35,682 1,298,967 39,250
Race/ethnicity: Hispanic 18,061 544,476 32,628
Race/ethnicity: Asian 6603 170,741 28,060
Race/ethnicity: Other/unknown 1618 48,109 31,975
Diagnosis: Diabetes 36,999 1,191,252 35,412
Diagnosis: Hypertension 29,902 903,522 32,633
Diagnosis: GN 26,389 748,325 30,093
Diagnosis: CKD 16,999 429,653 26,985
Diagnosis: Other 25,861 813,136 33,565
Outcome: Alive with function 125,028 3,383,923 28,433
Outcome: Dialysis/retransplant 4021 260,270 66,612
Outcome: Death with function 6647 398,931 126,631
Outcome: GF then death 454 42,765 159,170



Table Econ 5 Total and per person per year (PPPY) calendar-year Medicare costs of kidney transplant recipients, 2014
Costs paid by Medicare in 2014 for recipients alive with graft function in 2014, regardless of Medicare eligibility at the time of transplant. Costs incurred after transplant failure are excluded. Total costs are given in $1000 units and per person per year (PPPY) costs in $ units. Values for cells with 9 or fewer recipients are suppressed. CKD, cystic kidney disease; GF, graft failure; GN, glomerulonephritis.
Subgroup N Total ($1000) PPPY ($)
All recipients 139,304 4,246,199 32,809
Age: 0-11 1593 69,461 45,992
Age: 12-17 2651 121,632 48,106
Age: 18-34 21,708 791,132 38,240
Age: 35-49 40,493 1,206,846 31,651
Age: 50-64 52,658 1,435,352 29,533
Age: ≥65 20,201 621,776 34,618
Sex: Male 83,258 2,501,487 32,437
Sex: Female 56,046 1,744,712 33,358
Race/ethnicity: White 75,254 2,093,819 29,865
Race/ethnicity: Black 36,668 1,345,134 39,593
Race/ethnicity: Hispanic 18,766 567,122 32,591
Race/ethnicity: Asian 6945 184,245 28,796
Race/ethnicity: Other/unknown 1671 55,880 36,377
Diagnosis: Diabetes 38,108 1,255,732 36,107
Diagnosis: Hypertension 30,567 928,961 32,777
Diagnosis: GN 26,805 782,480 31,016
Diagnosis: CKD 17,492 438,761 26,721
Diagnosis: Other 26,332 840,265 34,083
Outcome: Alive with function 127,868 3,521,662 28,875
Outcome: Dialysis/retransplant 3841 252,442 67,480
Outcome: Death with function 7151 427,890 123,676
Outcome: GF then death 444 44,204 169,933



Table Econ 6 Average per person per year Medicare costs of pancreas transplant recipients during the year prior to transplant
Costs among recipients with Medicare as primary payer at the time of transplant, 2009-2014. Pretransplant costs exclude the transplant hospitalization. Per person per year (PPPY) costs in $ units. Cohort includes pancreas transplants with and without kidney. Values for cells with 9 or fewer recipients are suppressed.
Subgroup Patients, N Pre-tx, 365 days Pre-tx,90 days Pre-tx, 30 days
All recipients 2211 48,959 11,728 3273
Age: 0-11 * * * *
Age: 12-17 * * * *
Age: 18-34 535 58,816 14,008 4041
Age: 35-49 1258 48,058 11,571 3170
Age: 50-64 407 39,450 9320 2591
Age: ≥65 11 27,764 8245 2832
Sex: Male 1376 48,359 11,406 3225
Sex: Female 835 49,952 12,261 3352
Race/ethnicity: White 1392 44,585 10,733 3107
Race/ethnicity: Black 479 60,162 14,049 3961
Race/ethnicity: Hispanic 277 51,106 12,344 3092
Race/ethnicity: Asian 35 52,203 13,610 1987
Race/ethnicity: Other/unknown 28 50,523 13,369 3155
Diagnosis: Diabetes type 1 2003 48,715 11,672 3250
Diagnosis: Diabetes type 2 208 51,320 12,273 3492
Diagnosis: Other/unknown * * * *



Table Econ 7 Total and per person per year Medicare costs of pancreas transplant recipients in year 1 posttransplant
Costs for recipients with Medicare as primary payer at the time of transplant, 2008-2013. Year-1 costs include the transplant hospitalization. Costs incurred after transplant failure are excluded. Total costs are given in $1000 units and per person per year (PPPY) costs in $ units. Cohort includes pancreas transplants with and without kidney. Values for cells with 9 or fewer recipients are suppressed. GF, graft failure.
Subgroup N Total ($1000) PPPY ($)
All recipients 2940 317,843 110,326
Age: 0-11 * * *
Age: 12-17 * * *
Age: 18-34 696 77,441 112,882
Age: 35-49 1669 173,814 106,106
Age: 50-64 557 63,578 117,984
Age: ≥65 14 1858 133,568
Sex: Male 1856 191,793 105,374
Sex: Female 1084 126,051 118,824
Race/ethnicity: White 1852 195,685 108,236
Race/ethnicity: Black 633 72,211 115,263
Race/ethnicity: Hispanic 378 40,705 109,266
Race/ethnicity: Asian 46 5631 129,569
Race/ethnicity: Other/unknown 31 3612 118,316
Diagnosis: Diabetes type 1 2458 259,864 107,703
Diagnosis: Diabetes type 2 240 24,637 104,384
Diagnosis: Other/unknown 242 33,342 143,628
Outcome: Alive with function 2570 270,032 104,784
Outcome: GF/Retransplant 281 32,442 120,498
Outcome: Death with function 89 15,370 443,299



Table Econ 8 Total and per person per year Medicare costs of pancreas transplant recipients in year 2 posttransplant
Costs for recipients with Medicare as primary payer at the time of transplant, 2008-2012. Year 2 is from day 366 to day 730 posttransplant. Costs incurred after transplant failure are excluded. Total costs are given in $1000 units and per person per year (PPPY) costs in $ units. Cohort includes pancreas transplants with and without kidney. Values for cells with 9 or fewerrecipients are suppressed. GF, graft failure.
Subgroup N Total ($1000) PPPY ($)
All recipients 2099 67,103 32,130
Age: 0-11 * * *
Age: 12-17 * * *
Age: 18-34 506 18,777 37,048
Age: 35-49 1179 35,186 29,967
Age: 50-64 405 12,549 31,422
Age: ≥65 * * *
Sex: Male 1321 37,664 28,622
Sex: Female 778 29,439 38,104
Race/ethnicity: White 1324 41,938 31,830
Race/ethnicity: Black 458 16,382 35,930
Race/ethnicity: Hispanic 266 7248 27,367
Race/ethnicity: Asian 27 806 30,871
Race/ethnicity: Other/unknown 24 730 30,317
Diagnosis: Diabetes type 1 1755 55,412 31,718
Diagnosis: Diabetes type 2 170 4565 26,855
Diagnosis: Other/unknown 174 7127 41,558
Outcome: Alive with function 1996 59,962 29,959
Outcome: GF/Retransplant 73 4190 58,555
Outcome: Death with function 30 2951 190,686



Table Econ 9 Total and per person per year (PPPY) calendar-year Medicare costs of pancreas transplant recipients, 2013
Costs paid by Medicare in 2013 for recipients alive with graft function in 2013, regardless of Medicare eligibility at the time of transplant. Costs incurred after transplant failure are excluded. Total costs are given in $1000 units and per person per year (PPPY) costs in $ units. Cohort includes pancreas transplants with and without kidney. Values for cells with 9 or fewer recipients are suppressed. GF, graft failure.
Subgroup N Total ($1000) PPPY ($)
All recipients 10,318 312,211 32,019
Age: 0-11 * * *
Age: 12-17 11 641 63,096
Age: 18-34 2688 98,936 38,619
Age: 35-49 5858 164,904 29,776
Age: 50-64 1736 46,048 28,462
Age: ≥65 20 1218 66,739
Sex: Male 6203 175,704 30,042
Sex: Female 4115 136,506 34,980
Race/ethnicity: White 7802 221,738 29,956
Race/ethnicity: Black 1492 57,690 41,282
Race/ethnicity: Hispanic 844 26,994 34,282
Race/ethnicity: Asian 106 3667 38,375
Race/ethnicity: Other/unknown 74 2121 31,007
Diagnosis: Diabetes type 1 8446 254,444 31,833
Diagnosis: Diabetes type 2 682 19,556 31,034
Diagnosis: Other/unknown 1190 38,211 33,876
Outcome: Alive with function 9656 269,957 28,906
Outcome: GF/Retransplant 196 11,860 67,229
Outcome: Death with function 466 30,394 129,069



Table Econ 10 Total and per person per year (PPPY) calendar-year Medicare costs of pancreas transplant recipients, 2014
Costs paid by Medicare in 2014 for recipients alive with graft function in 2014, regardless of Medicare eligibility at the time of transplant. Costs incurred after transplant failure are excluded. Total costs are given in $1000 units and per person per year (PPPY) costs in $ units. Cohort includes pancreas transplants with and without kidney. Values for cells with 9 or fewer recipients are suppressed. GF, graft failure.
Subgroup N Total ($1000) PPPY ($)
All recipients 10,391 322,107 32,777
Age: 0-11 * * *
Age: 12-17 * * *
Age: 18-34 2714 103,048 39,972
Age: 35-49 5853 169,601 30,495
Age: 50-64 1790 48,102 29,064
Age: ≥65 21 641 32,544
Sex: Male 6210 184,165 31,413
Sex: Female 4181 137,942 34,792
Race/ethnicity: White 7774 219,805 29,760
Race/ethnicity: Black 1555 67,368 46,461
Race/ethnicity: Hispanic 875 29,246 35,683
Race/ethnicity: Asian 118 4094 38,395
Race/ethnicity: Other/unknown 69 1593 24,384
Diagnosis: Diabetes type 1 8521 259,429 32,156
Diagnosis: Diabetes type 2 694 23,512 36,503
Diagnosis: Other/unknown 1176 39,166 35,114
Outcome: Alive with function 9661 274,817 29,285
Outcome: GF/Retransplant 214 13,218 69,906
Outcome: Death with function 516 34,072 134,099



Table Econ 11 Average per person per year Medicare costs of liver transplant recipients during the year prior to transplant
Costs among recipients with Medicare as primary payer at the time of transplant, 2009-2014. Pretransplant costs exclude the transplant hospitalization. Per person per year (PPPY) costs in $ units. Values for cells with 9 or fewer recipients are suppressed. ALD, alcoholic liver disease; HCC, hepatocellular carcinoma; HCV, hepatitis C virus.
Subgroup Patients, N Pre-tx, 365 days Pre-tx,90 days Pre-tx, 30 days
All recipients 5724 50,002 21,577 8273
Age: 0-11 18 92,746 29,103 6557
Age: 12-17 * * * *
Age: 18-34 143 53,554 21,879 8698
Age: 35-49 656 58,695 25,762 9924
Age: 50-64 2862 50,542 21,599 8284
Age: ≥65 2042 45,899 20,151 7723
Sex: Male 3688 48,897 21,278 8252
Sex: Female 2036 52,011 22,122 8311
Race/ethnicity: White 4002 48,865 21,206 8135
Race/ethnicity: Black 584 51,882 21,339 8073
Race/ethnicity: Hispanic 844 55,855 24,467 9701
Race/ethnicity: Asian 226 41,246 17,110 6376
Race/ethnicity: Other/unknown 68 57,707 24,724 6716
Diagnosis: Acute liver failure 109 49,349 24,158 10,175
Diagnosis: HCV 1601 53,707 23,452 8940
Diagnosis: ALD 918 53,323 23,787 9386
Diagnosis: Cholestatic disease 410 48,071 21,276 8655
Diagnosis: HCC 1136 37,234 13,885 5258
Diagnosis: Other/unknown 1550 54,382 24,017 8899
MELD: Status 1A/1B 51 34,274 20,100 10,616
MELD: ≥ 35 960 62,751 34,832 13,972
MELD: 30-34 895 57,961 27,819 10,775
MELD: 15-29 3643 45,328 17,055 6319
MELD: < 15 173 43,669 13,800 4186
MELD: Other/unknown * * * *



Table Econ 12 Total and per person per year Medicare costs of liver transplant recipients in year 1 posttransplant
Costs for recipients with Medicare as primary payer at the time of transplant, 2008-2013. Year-1 costs include the transplant hospitalization. Costs incurred after transplant failure are excluded. Total costs are given in $1000 units and per person per year (PPPY) costs in $ units. Values for cells with 9 or fewer recipientss are suppressed. ALD, alcoholic liver disease; HCC, hepatocellular carcinoma; HCV, hepatitis C virus.
Subgroup N Total ($1000) PPPY ($)
All recipients 6991 1,182,668 184,786
Age: 0-11 22 5218 247,236
Age: 12-17 * * *
Age: 18-34 172 31,553 195,996
Age: 35-49 831 143,509 186,953
Age: 50-64 3535 597,087 184,314
Age: ≥65 2427 404,702 183,291
Sex: Male 4533 759,616 182,762
Sex: Female 2458 423,052 188,533
Race/ethnicity: White 4882 799,692 179,231
Race/ethnicity: Black 716 131,525 200,275
Race/ethnicity: Hispanic 1031 188,733 198,929
Race/ethnicity: Asian 281 49,004 189,218
Race/ethnicity: Other/unknown 81 13,714 185,398
Diagnosis: Acute liver failure 144 30,182 241,783
Diagnosis: HCV 1912 335,109 194,389
Diagnosis: ALD 1138 198,402 186,049
Diagnosis: Cholestatic disease 502 85,763 191,230
Diagnosis: HCC 1421 206,159 155,150
Diagnosis: Other/unknown 1874 327,053 191,503
MELD: Status 1A/1B 64 15,769 283,828
MELD: ≥ 35 1082 263,823 282,193
MELD: 30-34 1016 188,423 203,786
MELD: 15-29 4597 673,306 157,738
MELD: < 15 228 40,488 190,431
MELD: Other/unknown * * *
Outcome: Alive with function 5978 925,557 154,404
Outcome: Retransplant 149 47,838 388,392
Outcome: Death with function 864 209,273 740,360



Table Econ 13 Total and per person per year Medicare costs of liver transplant recipients in year 2 posttransplant
Costs for recipients with Medicare as primary payer at the time of transplant, 2008-2012. Year 2 is from day 366 to day 730 posttransplant. Costs incurred after transplant failure are excluded. Total costs are given in $1000 units and per person per year (PPPY) costs in $ units. Values for cells with 9 or fewer recipients are suppressed. ALD, alcoholic liver disease; HCC, hepatocellular carcinoma; HCV, hepatitis C virus.
Subgroup N Total ($1000) PPPY ($)
All recipients 4829 134,626 28,698
Age: 0-11 15 934 62,107
Age: 12-17 * * *
Age: 18-34 125 3650 30,102
Age: 35-49 598 16,400 28,029
Age: 50-64 2488 72,661 29,978
Age: ≥65 1600 40,927 26,526
Sex: Male 3150 86,146 28,177
Sex: Female 1679 48,480 29,672
Race/ethnicity: White 3363 90,905 27,696
Race/ethnicity: Black 498 16,165 33,988
Race/ethnicity: Hispanic 709 20,956 30,471
Race/ethnicity: Asian 201 5595 29,657
Race/ethnicity: Other/unknown 58 1006 17,659
Diagnosis: Acute liver failure 94 2483 27,327
Diagnosis: HCV 1279 37,084 29,990
Diagnosis: ALD 795 21,560 27,716
Diagnosis: Cholestatic disease 343 9857 29,610
Diagnosis: HCC 1020 28,644 29,298
Diagnosis: Other/unknown 1298 34,999 27,444
MELD: Status 1A/1B 44 1283 29,462
MELD: ≥ 35 649 19,155 30,489
MELD: 30-34 673 21,119 32,549
MELD: 15-29 3296 87,368 27,246
MELD: < 15 163 5522 34,529
MELD: Other/unknown * * *
Outcome: Alive with function 4529 113,394 24,969
Outcome: Retransplant 20 2402 122,588
Outcome: Death with function 280 18,830 144,650



Table Econ 14 Total and per person per year (PPPY) calendar-year Medicare costs of liver transplant recipients, 2013
Costs paid by Medicare in 2013 for recipients alive with graft function in 2013, regardless of Medicare eligibility at the time of transplant. Costs incurred after transplant failure are excluded. Total costs are given in $1000 units and per person per year (PPPY) costs in $ units. Values for cells with 9 or fewer recipients are suppressed. ALD, alcoholic liver disease; HCC, hepatocellular carcinoma; HCV, hepatitis C virus.
Subgroup N Total ($1000) PPPY ($)
All recipients 29,144 709,085 26,143
Age: 0-11 134 4930 38,248
Age: 12-17 102 2637 26,466
Age: 18-34 1087 26,073 24,974
Age: 35-49 6252 136,546 22,966
Age: 50-64 17,130 388,618 24,248
Age: ≥65 4439 150,281 38,750
Sex: Male 19,003 451,349 25,526
Sex: Female 10,141 257,736 27,298
Race/ethnicity: White 21,866 511,400 25,085
Race/ethnicity: Black 2363 70,842 32,653
Race/ethnicity: Hispanic 3540 95,493 29,151
Race/ethnicity: Asian 1113 24,420 23,351
Race/ethnicity: Other/unknown 262 6929 28,271
Diagnosis: Acute liver failure 1199 22,990 19,957
Diagnosis: HCV 7287 184,782 27,412
Diagnosis: ALD 5656 131,693 24,983
Diagnosis: Cholestatic disease 3222 69,007 22,528
Diagnosis: HCC 3382 82,592 27,135
Diagnosis: Other/unknown 8398 218,022 27,766
MELD: Status 1A/1B 1331 24,687 19,275
MELD: ≥ 35 2985 110,601 41,383
MELD: 30-34 2598 76,395 32,607
MELD: 15-29 14,420 327,262 24,465
MELD: < 15 1345 32,836 25,511
MELD: Other/unknown 6465 137,303 22,280
Outcome: Alive with function 27,138 581,871 22,244
Outcome: Retransplant 108 17,962 207,633
Outcome: Death with function 1898 109,252 124,513



Table Econ 15 Total and per person per year (PPPY) calendar-year Medicare costs of liver transplant recipients, 2014
Costs paid by Medicare in 2014 for recipients alive with graft function in 2014, regardless of Medicare eligibility at the time of transplant. Costs incurred after transplant failure are excluded. Total costs are given in $1000 units and per person per year (PPPY) costs in $ units. Values for cells with 9 or fewer recipients are suppressed. ALD, alcoholic liver disease; HCC, hepatocellular carcinoma; HCV, hepatitis C virus.
Subgroup N Total ($1000) PPPY ($)
All recipients 30,539 739,423 25,989
Age: 0-11 141 5333 38,398
Age: 12-17 104 3767 37,546
Age: 18-34 1110 27,222 25,821
Age: 35-49 6262 135,545 22,756
Age: 50-64 18,105 404,202 23,825
Age: ≥65 4817 163,355 38,571
Sex: Male 19,926 471,623 25,477
Sex: Female 10,613 267,799 26,943
Race/ethnicity: White 22,840 537,038 25,239
Race/ethnicity: Black 2500 72,942 31,719
Race/ethnicity: Hispanic 3744 97,868 27,971
Race/ethnicity: Asian 1173 24,351 21,903
Race/ethnicity: Other/unknown 282 7224 27,547
Diagnosis: Acute liver failure 1214 23,910 20,618
Diagnosis: HCV 7654 194,031 27,484
Diagnosis: ALD 5877 140,636 25,563
Diagnosis: Cholestatic disease 3324 69,744 22,083
Diagnosis: HCC 3728 88,495 26,107
Diagnosis: Other/unknown 8742 222,606 27,207
MELD: Status 1A/1B 1329 26,452 20,820
MELD: ≥ 35 3532 129,760 40,395
MELD: 30-34 2919 84,984 31,960
MELD: 15-29 15,308 342,864 24,136
MELD: < 15 1376 31,381 23,988
MELD: Other/unknown 6075 123,982 21,394
Outcome: Alive with function 28,414 606,745 22,144
Outcome: Retransplant 118 17,705 186,934
Outcome: Death with function 2007 114,973 120,286



Table Econ 16 Average per person per year Medicare costs of intestinal transplant recipients during the year prior to transplant
Costs among recipients with Medicare as primary payer at the time of transplant, 2009-2014. Pretransplant costs exclude the transplant hospitalization. Per person per year (PPPY) costs in $ units. Values for cells with 9 or fewer recipients are suppressed. IN, intestine without liver; IN-LI, intestine with liver; NEC, necrotizing enterocolitis; SGS, short-gut syndrome.
Subgroup Patients, N Pre-tx, 365 days Pre-tx,90 days Pre-tx, 30 days
All recipients 58 130,057 36,379 12,226
Age: 0-11 * * * *
Age: 12-17 * * * *
Age: 18-34 11 142,159 35,590 14,081
Age: 35-49 19 143,782 43,213 13,190
Age: 50-64 23 118,150 33,936 11,300
Age: ≥65 * * * *
Sex: Male 23 108,991 31,973 12,423
Sex: Female 35 143,900 39,275 12,096
Race/ethnicity: White 46 132,258 36,743 12,022
Race/ethnicity: Black * * * *
Race/ethnicity: Hispanic * * * *
Race/ethnicity: Asian * * * *
Race/ethnicity: Other/unknown * * * *
Diagnosis: NEC * * * *
Diagnosis: Congenital SGS * * * *
Diagnosis: Other SGS 45 131,919 35,093 12,330
Diagnosis: Pseudo-obstruction * * * *
Diagnosis: Enteropathies * * * *
Diagnosis: Other/unknown * * * *
Tx type: IN 44 145,386 41,467 12,959
Tx type: IN-LI 14 81,879 20,391 9919



Table Econ 17 Total and per person per year Medicare costs of intestine transplant recipients in year 1 posttransplant
Costs for recipients with Medicare as primary payer at the time of transplant, 2008-2013. Year-1 costs include the transplant hospitalization. Costs incurred after transplant failure are excluded. Total costs are given in $1000 units and per person per year (PPPY) costs in $ units. Values for cells with 9 or fewer recipients are suppressed. GF, graft failure; IN, intestine without liver; IN-LI, intestine with liver; NEC, necrotizing enterocolitis; SGS, short-gut syndrome.
Subgroup N Total ($1000) PPPY ($)
All recipients 71 22,374 366,144
Age: 0-11 * * *
Age: 12-17 * * *
Age: 18-34 11 3896 470,910
Age: 35-49 23 5823 271,426
Age: 50-64 29 10,413 428,151
Age: ≥65 * * *
Sex: Male 29 9050 345,876
Sex: Female 42 13,324 381,320
Race/ethnicity: White 59 18,208 355,926
Race/ethnicity: Black * * *
Race/ethnicity: Hispanic * * *
Race/ethnicity: Asian * * *
Race/ethnicity: Other/unknown * * *
Diagnosis: NEC * * *
Diagnosis: Congenital SGS * * *
Diagnosis: Other SGS 53 16,156 360,462
Diagnosis: Pseudo-obstruction * * *
Diagnosis: Enteropathies * * *
Diagnosis: Other/unknown 13 4822 396,043
Tx type: IN 51 16,027 361,419
Tx type: IN-LI 20 6347 378,644
Outcome: Alive with function 50 15,117 301,512
Outcome: GF/Retransplant * * *
Outcome: Death with function 14 5821 1,041,527



Table Econ 18 Total and per person per year Medicare costs of intestine transplant recipients in year 2 posttransplant
Costs for recipients with Medicare as primary payer at the time of transplant, 2008-2012. Year 2 is from day 366 to day 730 posttransplant. Costs incurred after transplant failure are excluded. Total costs are given in $1000 units and per person per year (PPPY) costs in $ units. Values for cells with 9 or fewer recipients are suppressed. GF, graft failure; IN, intestine without liver; IN-LI, intestine with liver; NEC, necrotizing enterocolitis; SGS, short-gut syndrome.
Subgroup N Total ($1000) PPPY ($)
All recipients 44 4123 104,729
Age: 0-11 * * *
Age: 12-17 * * *
Age: 18-34 * * *
Age: 35-49 18 1681 102,925
Age: 50-64 17 1285 85,774
Age: ≥65 * * *
Sex: Male 18 856 54,627
Sex: Female 26 3267 137,869
Race/ethnicity: White 37 3600 110,687
Race/ethnicity: Black * * *
Race/ethnicity: Hispanic * * *
Race/ethnicity: Asian * * *
Race/ethnicity: Other/unknown * * *
Diagnosis: NEC * * *
Diagnosis: Congenital SGS * * *
Diagnosis: Other SGS 33 2880 100,256
Diagnosis: Pseudo-obstruction * * *
Diagnosis: Enteropathies * * *
Diagnosis: Other/unknown 10 1022 106,091
Tx type: IN 31 3003 112,357
Tx type: IN-LI 13 1120 88,606
Outcome: Alive with function 34 3009 88,260
Outcome: GF/Retransplant * * *
Outcome: Death with function * * *



Table Econ 19 Total and per person per year (PPPY) calendar-year Medicare costs of intestine transplant recipients, 2013
Costs paid by Medicare in 2013 for recipients alive with graft function in 2013, regardless of Medicare eligibility at the time of transplant. Costs incurred after transplant failure are excluded. Total costs are given in $1000 units and per person per year (PPPY) costs in $ units. Values for cells with 9 or fewer recipients are suppressed. GF, graft failure; IN, intestine without liver; IN-LI, intestine with liver; NEC, necrotizing enterocolitis; SGS, short-gut syndrome.
Subgroup N Total ($1000) PPPY ($)
All recipients 276 15,108 59,784
Age: 0-11 * * *
Age: 12-17 * * *
Age: 18-34 75 5206 72,158
Age: 35-49 103 4461 47,534
Age: 50-64 79 4390 64,237
Age: ≥65 * * *
Sex: Male 118 5232 49,870
Sex: Female 158 9875 66,822
Race/ethnicity: White 228 12,250 58,799
Race/ethnicity: Black 27 1529 60,421
Race/ethnicity: Hispanic 16 735 52,252
Race/ethnicity: Asian * * *
Race/ethnicity: Other/unknown * * *
Diagnosis: NEC * * *
Diagnosis: Congenital SGS * * *
Diagnosis: Other SGS 197 9971 55,320
Diagnosis: Pseudo-obstruction 27 1671 66,186
Diagnosis: Enteropathies * * *
Diagnosis: Other/unknown 44 2747 68,444
Tx type: IN 184 11,063 66,152
Tx type: IN-LI 92 4045 47,325
Outcome: Alive with function 240 10,606 46,228
Outcome: GF/Retransplant 14 2490 214,247
Outcome: Death with function 22 2011 172,709



Table Econ 20 Total and per person per year (PPPY) calendar-year Medicare costs of intestine transplant recipients, 2014
Costs paid by Medicare in 2014 for recipients alive with graft function in 2014, regardless of Medicare eligibility at the time of transplant. Costs incurred after transplant failure are excluded. Total costs are given in $1000 units and per person per year (PPPY) costs in $ units. Values for cells with 9 or fewer recipients are suppressed. GF, graft failure; IN, intestine without liver; IN-LI, intestine with liver; NEC, necrotizing enterocolitis; SGS, short-gut syndrome.
Subgroup N Total ($1000) PPPY ($)
All recipients 279 14,867 58,649
Age: 0-11 * * *
Age: 12-17 * * *
Age: 18-34 69 3831 59,724
Age: 35-49 107 4646 46,366
Age: 50-64 85 5286 73,139
Age: ≥65 * * *
Sex: Male 118 5229 50,192
Sex: Female 161 9638 64,551
Race/ethnicity: White 225 12,066 59,417
Race/ethnicity: Black 32 1834 60,214
Race/ethnicity: Hispanic 18 736 44,554
Race/ethnicity: Asian * * *
Race/ethnicity: Other/unknown * * *
Diagnosis: NEC * * *
Diagnosis: Congenital SGS * * *
Diagnosis: Other SGS 200 10,427 57,819
Diagnosis: Pseudo-obstruction 25 1568 62,986
Diagnosis: Enteropathies * * *
Diagnosis: Other/unknown 46 2641 64,057
Tx type: IN 172 9214 58,909
Tx type: IN-LI 107 5653 58,230
Outcome: Alive with function 238 10,244 44,305
Outcome: GF/Retransplant * * *
Outcome: Death with function 32 2845 189,945



Table Econ 21 Average per person per year Medicare costs of heart transplant recipients during the year prior to transplant
Costs among recipients with Medicare as primary payer at the time of transplant, 2009-2014. Pretransplant costs exclude the transplant hospitalization. Per person per year (PPPY) costs in $ units. Values for cells with 9 or fewer recipients are suppressed. CAD, coronary artery disease.
Subgroup Patients, N Pre-tx, 365 days Pre-tx,90 days Pre-tx, 30 days
All recipients 2675 111,899 26,921 7195
Age: 0-11 * * * *
Age: 12-17 * * * *
Age: 18-34 128 107,087 30,180 7539
Age: 35-49 427 112,105 27,834 6918
Age: 50-64 1108 113,901 28,084 7287
Age: ≥65 1012 110,231 24,844 7167
Sex: Male 2049 116,201 27,264 7020
Sex: Female 626 97,833 25,801 7766
Race/ethnicity: White 1817 108,920 25,664 7004
Race/ethnicity: Black 593 118,733 29,550 7668
Race/ethnicity: Hispanic 182 124,322 32,001 7876
Race/ethnicity: Asian 62 96,188 23,710 6805
Race/ethnicity: Other/unknown 21 115,947 26,981 5590
Diagnosis: CAD 1225 116,508 25,457 7093
Diagnosis: Cardiomyopathy 1294 111,203 28,421 7283
Diagnosis: Congenital 54 65,516 25,925 7947
Diagnosis: Valvular 57 77,124 21,557 7236
Diagnosis: Other/unknown 45 106,667 31,636 6468



Table Econ 22 Total and per person per year Medicare costs among heart transplant recipients in year 1 posttransplant
Costs among recipients with Medicare as primary payer at the time of transplant, 2008-2013. Year-1 costs include the transplant hospitalization. Costs incurred after a transplant failure are excluded. Total costs are given in $1000 units and per person per year (PPPY) costs in $ units. Values for cells with 9 or fewer recipients are suppressed. CAD, coronary artery disease.
Subgroup N Total ($1000) PPPY ($)
All recipients 3135 875,144 304,692
Age: 0-11 * * *
Age: 12-17 * * *
Age: 18-34 157 45,028 304,807
Age: 35-49 511 149,806 317,076
Age: 50-64 1315 362,104 298,807
Age: ≥65 1150 316,459 304,815
Sex: Male 2391 666,950 303,505
Sex: Female 744 208,194 308,557
Race/ethnicity: White 2127 589,049 299,931
Race/ethnicity: Black 688 193,072 313,612
Race/ethnicity: Hispanic 225 63,973 314,656
Race/ethnicity: Asian 70 22,175 332,017
Race/ethnicity: Other/unknown 25 6876 305,079
Diagnosis: CAD 1441 398,431 303,754
Diagnosis: Cardiomyopathy 1517 420,588 299,987
Diagnosis: Congenital 65 21,971 388,841
Diagnosis: Valvular 62 18,435 323,783
Diagnosis: Other/unknown 50 15,719 348,771
Outcome: Alive with function 2763 752,568 271,629
Outcome: Retransplant * * *
Outcome: Death with function 368 121,500 1,219,640



Table Econ 23 Total and per person per year Medicare costs among heart transplant recipients in year 2 posttransplant
Costs among recipients with Medicare as primary payer at the time of transplant, 2008-2012. Year 2 is from day 366 to day 730 posttransplant. Costs incurred after a transplant failure are excluded. Total costs are given in $1000 units and per person per year (PPPY) costs in $ units. Values for cells with 9 or fewer recipients are suppressed. CAD, coronary artery disease.
Subgroup N Total ($1000) PPPY ($)
All recipients 2223 77,972 35,825
Age: 0-11 * * *
Age: 12-17 * * *
Age: 18-34 116 4241 37,467
Age: 35-49 367 15,067 42,424
Age: 50-64 959 33,660 35,925
Age: ≥65 779 24,879 32,338
Sex: Male 1697 58,276 35,052
Sex: Female 526 19,696 38,330
Race/ethnicity: White 1529 53,669 35,893
Race/ethnicity: Black 465 16,829 36,785
Race/ethnicity: Hispanic 163 5460 34,154
Race/ethnicity: Asian 49 1402 29,790
Race/ethnicity: Other/unknown 17 612 36,503
Diagnosis: CAD 1032 36,778 36,374
Diagnosis: Cardiomyopathy 1071 36,868 35,136
Diagnosis: Congenital 45 1634 37,825
Diagnosis: Valvular 43 972 22,538
Diagnosis: Other/unknown 32 1721 57,828
Outcome: Alive with function 2119 68,663 32,315
Outcome: Retransplant * * *
Outcome: Death with function 97 7064 157,305



Table Econ 24 Total and per person per year (PPPY) calendar-year Medicare costs of heart transplant recipients, 2013
Costs paid by Medicare in 2013 for recipients alive with graft function in 2013, regardless of Medicare eligibility at the time of transplant. Costs incurred after transplant failure are excluded. Total costs are given in $1000 units and per person per year (PPPY) costs in $ units. Values for cells with 9 or fewer recipients are suppressed. CAD, coronary artery disease.
Subgroup N Total ($1000) PPPY ($)
All recipients 13,735 463,976 36,329
Age: 0-11 54 1833 35,001
Age: 12-17 54 1184 22,263
Age: 18-34 823 28,002 35,567
Age: 35-49 2894 88,874 32,671
Age: 50-64 7707 233,350 32,376
Age: ≥65 2203 110,733 56,758
Sex: Male 10,805 358,681 35,745
Sex: Female 2930 105,295 38,471
Race/ethnicity: White 10,462 335,053 34,415
Race/ethnicity: Black 2101 89,982 46,353
Race/ethnicity: Hispanic 802 24,800 32,912
Race/ethnicity: Asian 277 11,266 43,952
Race/ethnicity: Other/unknown 93 2875 34,020
Diagnosis: CAD 6424 214,912 36,168
Diagnosis: Cardiomyopathy 6478 221,240 36,577
Diagnosis: Congenital 307 9209 31,527
Diagnosis: Valvular 327 10,154 33,740
Diagnosis: Other/unknown 199 8460 45,062
Outcome: Alive with function 12,732 395,412 32,207
Outcome: Retransplant 32 4675 157,719
Outcome: Death with function 971 63,889 137,440



Table Econ 25 Total and per person per year (PPPY) calendar-year Medicare costs of heart transplant recipients, 2014
Costs paid by Medicare in 2014 for recipients alive with graft function in 2014, regardless of Medicare eligibility at the time of transplant. Costs incurred after transplant failure are excluded. Total costs are given in $1000 units and per person per year (PPPY) costs in $ units. Values for cells with 9 or fewer recipients are suppressed. CAD, coronary artery disease.
Subgroup N Total ($1000) PPPY ($)
All recipients 14,113 485,497 37,171
Age: 0-11 56 2205 40,392
Age: 12-17 60 2028 35,071
Age: 18-34 868 27,256 33,348
Age: 35-49 2923 90,680 33,059
Age: 50-64 7773 236,107 32,640
Age: ≥65 2433 127,221 59,039
Sex: Male 11,024 371,641 36,449
Sex: Female 3089 113,856 39,741
Race/ethnicity: White 10,601 338,595 34,422
Race/ethnicity: Black 2266 100,434 48,467
Race/ethnicity: Hispanic 863 31,863 40,135
Race/ethnicity: Asian 294 11,014 39,936
Race/ethnicity: Other/unknown 89 3590 43,431
Diagnosis: CAD 6441 217,022 36,571
Diagnosis: Cardiomyopathy 6792 239,912 38,068
Diagnosis: Congenital 332 10,693 34,297
Diagnosis: Valvular 339 10,486 33,136
Diagnosis: Other/unknown 209 7384 37,570
Outcome: Alive with function 13,027 409,661 32,651
Outcome: Retransplant 26 3241 130,117
Outcome: Death with function 1060 72,595 148,285



Table Econ 26 Average per person per year Medicare costs of lung transplant recipients during the year prior to transplant
Costs among recipients with Medicare as primary payer at the time of transplant, 2009-2014. Pretransplant costs exclude the transplant hospitalization. Per person per year (PPPY) costs in $ units. Values for cells with 9 or fewer recipients are suppressed. A, obstructive lung disease; B, pulmonary vascular disease; C, cystic fibrosis; D, restrictive lung disease; LAS, lung allocation score.
Subgroup Patients, N Pre-tx, 365 days Pre-tx,90 days Pre-tx, 30 days
All recipients 2635 32,201 10,684 3694
Age: 0-11 * * * *
Age: 12-17 * * * *
Age: 18-34 177 94,774 29,910 8148
Age: 35-49 240 56,319 17,548 5542
Age: 50-64 862 29,318 9594 3544
Age: ≥65 1356 21,812 7709 2882
Sex: Male 1605 29,103 10,084 3684
Sex: Female 1030 37,062 11,630 3711
Race/ethnicity: White 2265 31,543 10,383 3679
Race/ethnicity: Black 208 35,413 12,111 3406
Race/ethnicity: Hispanic 116 40,855 13,268 3946
Race/ethnicity: Asian 30 25,886 10,584 5197
Race/ethnicity: Other/unknown 16 32,157 16,363 4974
Diagnosis group: A 953 23,206 7129 2517
Diagnosis group: B 100 100,300 28,446 5224
Diagnosis group: C 202 90,872 27,112 8329
Diagnosis group: D 1380 25,132 9493 3719
Diagnosis group: Other/unknown * * * *
LAS: <30 * * * *
LAS: 30-< 35 727 23,342 6534 2093
LAS: 35-< 40 587 32,293 9626 3215
LAS: 40-< 45 666 34,563 10,633 3159
LAS: 45-< 50 258 32,564 12,299 4358
LAS: 50-< 60 393 44,631 19,154 7837
LAS: ≥ 60 * * * *



Table Econ 27 Total and per person per year Medicare costs of lung transplant recipients in year 1 posttransplant
Costs for recipients with Medicare as primary payer at the time of transplant, 2008-2013. Year-1 costs include the transplant hospitalization. Costs incurred after transplant failure are excluded. Total costs are given in $1000 units and per person per year (PPPY) costs in $ units. Values for cells with 9 or fewer recipients are suppressed. A, obstructive lung disease; B, pulmonary vascular disease; C, cystic fibrosis; D, restrictive lung disease; LAS, lung allocation score.
Subgroup N Total ($1000) PPPY ($)
All recipients 3118 674,353 238,764
Age: 0-11 * * *
Age: 12-17 * * *
Age: 18-34 215 50,382 254,453
Age: 35-49 289 67,999 259,184
Age: 50-64 1052 214,650 223,776
Age: ≥65 1562 341,322 242,973
Sex: Male 1907 413,534 241,740
Sex: Female 1211 260,819 234,192
Race/ethnicity: White 2673 574,062 235,785
Race/ethnicity: Black 253 56,210 253,987
Race/ethnicity: Hispanic 137 31,449 268,058
Race/ethnicity: Asian 35 8587 261,079
Race/ethnicity: Other/unknown 20 4045 223,003
Diagnosis group: A 1162 226,914 212,275
Diagnosis group: B 119 30,854 292,538
Diagnosis group: C 237 52,592 234,911
Diagnosis group: D 1600 363,992 255,248
Diagnosis group: Other/unknown * * *
LAS: <30 * * *
LAS: 30-< 35 880 168,722 209,087
LAS: 35-< 40 706 148,294 227,633
LAS: 40-< 45 779 169,791 241,691
LAS: 45-< 50 302 67,234 254,539
LAS: 50-< 60 442 118,611 303,865
LAS: ≥ 60 * * *
Outcome: Alive with function 2596 509,622 195,774
Outcome: Retransplant 52 19,894 642,357
Outcome: Death with function 470 144,837 761,235



Table Econ 28 Total and per person per year Medicare costs of lung transplant recipients in year 2 posttransplant
Costs for recipients with Medicare as primary payer at the time of transplant, 2008-2012. Year 2 is from day 366 to day 730 days posttransplant. Costs incurred after transplant failure are excluded. Total costs are given in $1000 units and per person per year (PPPY) costs in $ units. Values for cells with 9 or fewer recipients are suppressed. A, obstructive lung disease; B, pulmonary vascular disease; C, cystic fibrosis; D, restrictive lung disease; LAS, lung allocation score.
Subgroup N Total ($1000) PPPY ($)
All recipients 2092 102,127 51,757
Age: 0-11 * * *
Age: 12-17 * * *
Age: 18-34 148 8311 58,708
Age: 35-49 212 10,107 50,461
Age: 50-64 726 35,235 50,968
Age: ≥65 1006 48,474 51,567
Sex: Male 1244 58,468 49,993
Sex: Female 848 43,659 54,325
Race/ethnicity: White 1815 89,274 52,052
Race/ethnicity: Black 153 6470 46,201
Race/ethnicity: Hispanic 82 4524 57,240
Race/ethnicity: Asian 28 1222 46,884
Race/ethnicity: Other/unknown 14 638 49,195
Diagnosis group: A 827 41,213 52,352
Diagnosis group: B 85 4626 58,383
Diagnosis group: C 175 9742 57,455
Diagnosis group: D 1005 46,546 49,667
Diagnosis group: Other/unknown * * *
LAS: <30 * * *
LAS: 30-< 35 622 30,881 52,126
LAS: 35-< 40 492 24,651 52,795
LAS: 40-< 45 518 23,500 48,433
LAS: 45-< 50 196 9957 54,280
LAS: 50-< 60 257 12,976 54,471
LAS: ≥ 60 * * *
Outcome: Alive with function 1835 74,716 40,606
Outcome: Retransplant 24 4961 261,330
Outcome: Death with function 233 22,450 196,614



Table Econ 29 Total and per person per year (PPPY) calendar-year Medicare costs of lung transplant recipients, 2013
Costs paid by Medicare in 2013 for recipients alive with graft function in 2013, regardless of Medicare eligibility at the time of transplant. Costs incurred after transplant failure are excluded. Total costs are given in $1000 units and per person per year (PPPY) costs in $ units. Values for cells with 9 or fewer recipients are suppressed. A, obstructive lung disease; B, pulmonary vascular disease; C, cystic fibrosis; D, restrictive lung disease; LAS, lung allocation score.
Subgroup N Total ($1000) PPPY ($)
All recipients 6959 301,482 49,425
Age: 0-11 * * *
Age: 12-17 12 487 46,057
Age: 18-34 582 28,415 53,274
Age: 35-49 1091 37,409 37,212
Age: 50-64 3519 124,943 39,718
Age: ≥65 1749 110,150 78,748
Sex: Male 4009 186,052 53,532
Sex: Female 2950 115,430 43,987
Race/ethnicity: White 5927 251,812 48,536
Race/ethnicity: Black 604 29,938 56,080
Race/ethnicity: Hispanic 313 13,307 48,405
Race/ethnicity: Asian 78 3749 53,154
Race/ethnicity: Other/unknown 37 2676 82,655
Diagnosis group: A 2714 110,425 46,287
Diagnosis group: B 322 12,179 41,669
Diagnosis group: C 651 26,179 43,922
Diagnosis group: D 3228 151,687 54,524
Diagnosis group: Other/unknown 44 1011 23,122
LAS: <30 18 395 23,115
LAS: 30-< 35 1656 74,447 51,828
LAS: 35-< 40 1277 54,293 48,792
LAS: 40-< 45 1312 60,243 52,634
LAS: 45-< 50 500 25,546 59,606
LAS: 50-< 60 829 48,541 70,427
LAS: ≥ 60 1367 38,017 29,910
Outcome: Alive with function 6114 230,332 40,456
Outcome: Retransplant 60 9728 205,450
Outcome: Death with function 785 61,422 171,055



Table Econ 30 Total and per person per year (PPPY) calendar-year Medicare costs of lung transplant recipients, 2014
Costs paid by Medicare in 2014 for recipients alive with graft function in 2014, regardless of Medicare eligibility at the time of transplant. Costs incurred after transplant failure are excluded. Total costs are given in $1000 units and per person per year (PPPY) costs in $ units. Values for cells with 9 or fewer recipients are suppressed. A, obstructive lung disease; B, pulmonary vascular disease; C, cystic fibrosis; D, restrictive lung disease; LAS, lung allocation score.
Subgroup N Total ($1000) PPPY ($)
All recipients 7339 308,609 47,614
Age: 0-11 * * *
Age: 12-17 11 754 69,079
Age: 18-34 592 28,395 52,450
Age: 35-49 1109 36,766 35,818
Age: 50-64 3691 130,205 39,294
Age: ≥65 1930 112,275 70,919
Sex: Male 4255 182,519 49,041
Sex: Female 3084 126,090 45,690
Race/ethnicity: White 6248 261,222 47,459
Race/ethnicity: Black 617 27,952 50,238
Race/ethnicity: Hispanic 345 13,726 45,440
Race/ethnicity: Asian 94 3911 45,646
Race/ethnicity: Other/unknown 35 1798 54,310
Diagnosis group: A 2731 103,549 42,564
Diagnosis group: B 328 12,719 42,022
Diagnosis group: C 681 32,457 52,173
Diagnosis group: D 3560 158,894 51,453
Diagnosis group: Other/unknown 39 990 27,680
LAS: <30 17 525 35,020
LAS: 30-< 35 1723 70,778 46,218
LAS: 35-< 40 1346 54,401 45,939
LAS: 40-< 45 1457 64,373 50,567
LAS: 45-< 50 569 23,795 49,444
LAS: 50-< 60 1011 60,244 69,197
LAS: ≥ 60 1216 34,493 30,634
Outcome: Alive with function 6468 236,272 39,048
Outcome: Retransplant 61 11,196 214,452
Outcome: Death with function 810 61,141 161,583