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E1083. Increasing Utilization of Renal Transplant Ultrasound in the Medicare Population, 2010-2018
Authors
  1. Andrew Kolarich; The Johns Hopkins Hospital
  2. Sheila Sheth; The Johns Hopkins Hospital
Objective:
Evaluation of renal transplants with ultrasound has an established role in the immediate post-operative and long-term evaluation of renal transplant grafts (1). However, there is no standardized protocol for regarding the use of renal transplant ultrasound nationally. As a result, we were interested in evaluating trends in renal transplant ultrasound over time utilizing a large national database.

Materials and Methods:
Physician Summary Supplier Master Files from the Centers for Medicare Services (CMS) were obtained; institutional review board exemption was granted for these publicly available data files. Renal transplant ultrasound was identified using the Common Procedural Terminology (CPT) code 76776, defined as “renal transplant ultrasound with Doppler”. Surgical implantation of renal transplants were identified with codes 50360 and 50365 to include those which occurred with simultaneous nephrectomy. Number of renal transplant ultrasounds, renal transplants, and number of Medicare fee-for-service enrollees were evaluated. Statistical analysis was performed using SPSS version 25 (2017 IBM Corp, Armonk, NY).

Results:
453,812 renal transplant ultrasounds and 130,159 renal transplants were performed from 2010-2018. 43,861 renal ultrasounds were performed in 2010 with procedure volume increasing yearly to 59,590 in 2018, representing a 35.9% increase. During the same study period, renal transplant volume increased from 13,342 to 16,220 representing a 20.8% increase. When controlled for total Medicare enrollment, both renal ultrasound exams and renal transplantation increased. In 2010, 37.1 renal transplants were performed per 100,000 enrollees; in 2018 41.9 were performed by 100,000 enrollees. Renal transplant ultrasounds increased from 121.8 to 154.1 per 100,000 Medicare enrollees. Over the study period, the ratio of renal transplant ultrasound to renal transplants increased 12%, from 3.3 to 3.7.

Conclusion:
Utilizing a large national database, our analysis demonstrates that both renal transplantation and renal transplant ultrasound volume has increased even when controlling for growth in the Medicare population. Further analysis to evaluate underlying reasons for the increasing number of renal ultrasounds performed per transplant is warranted.