I checked the numbers on this recently. An average heart transplant costs about 1.1 million dollars, and has a mean survival time of about five years (at a very poor QoL). I think there's a pretty strong case that they shouldn't be done at all.
Kidney transplants have a much better RoI, but they don't require the death of the donor.
Correction: the median post-heart-transplant survival time seems to be a little over 10 years now, so the mean is probably close to that.. However, it's important to note that organ transplants aren't performed just before the patient dies of natural causes, so there's overlap between post-transplant survival and the lifespan the patient would have had without a transplant.
Case in point: An acquaintance with COPD had a lung transplant, then died a year later of related causes. His condition at the time of the lung transplant wasn't good but wasn't that di...
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