Brigham Mark D, Milgroom Andrew, Lenco Mara Onita, Tudor Thilan, Kent Jeffrey D, LaMoreaux Brian, Johnson Richard J, Mandell Brian F, Hadker Nandini, Francis Kevin, Sanchez Herman, Radeck Lauren P, Li Justin W
Trinity Partners LLC, Waltham, Massachusetts, United States.
Horizon Pharma USA Inc, Medical Affairs, Lake Forest, Illinois, United States.
Transplant Proc. 2019 Dec;51(10):3449-3455. doi: 10.1016/j.transproceed.2019.08.037. Epub 2019 Nov 14.
Although incidence and survival are frequent topics within the solid organ transplantation (SOT) literature, the size of the surviving SOT population is not well known. Existing studies of gout in patients with SOT have focused on the incident SOT population. This analysis was performed to characterize the prevalent SOT population and the prevalence of gout within it.
This study includes the 2017 United States (US) population size of recipients of kidney, heart, liver, and lung transplants that was estimated by combining primary transplant recipient cohort sizes (1988-2017) with previously published survival rates for each annual cohort's time since transplantation (0-29 years). Gout among prevalent patients with SOT was assessed using Medicare and commercial claims.
A total of 637,231 US patients received a primary kidney (393,953), liver (142,186), heart (66,637), or lung (34,455) transplant between 1988 and 2017. An estimated 356,000 (55.8%) recipients were alive in 2017 (233,000 kidney; 78,700 liver; 29,300 heart; 14,700 lung). Gout was identified in 11% of prevalent patients with SOT in 2016. Higher rates of gout were seen in recipients of kidney (13.1%) and heart (12.7%) compared to recipients of liver (6.7%) and lung (5.6%) (P < .0001 in both datasets). Active diagnosed gout prevalence in the US population without a SOT history was 1.1% in 2016.
Hundreds of thousands of US patients are living with a transplanted organ today and these numbers are likely to increase. In patients with SOT, gout is a frequent comorbidity of which physicians should be aware. This study suggests a markedly higher rate of gout among transplant recipients compared to the general US population.
虽然发病率和生存率是实体器官移植（SOT）文献中常见的话题，但存活的SOT人群规模尚不清楚。现有的关于SOT患者痛风的研究主要集中在新发SOT人群。本分析旨在描述SOT现患人群的特征及其痛风患病率。
本研究纳入了2017年美国肾脏、心脏、肝脏和肺移植受者的人群规模，该规模通过将原发性移植受者队列规模（1988 - 2017年）与先前发表的各年度队列自移植后不同时间（0 - 29年）的生存率相结合来估算。利用医疗保险和商业医保理赔数据评估SOT现患患者中的痛风情况。
1988年至2017年间，共有637,231名美国患者接受了原发性肾脏（393,953例）、肝脏（142,186例）、心脏（66,637例）或肺（34,455例）移植。2017年估计有356,000名（55.8%）受者存活（233,000例肾脏；78,700例肝脏；29,300例心脏；14,700例肺）。2016年，11%的SOT现患患者被诊断为痛风。与肝脏（6.7%）和肺（5.6%）移植受者相比，肾脏（13.1%）和心脏（12.7%）移植受者的痛风发生率更高（两个数据集的P均<0.0001）。2016年，无SOT病史的美国人群中确诊的活动性痛风患病率为1.1%。
如今，美国有成千上万的患者移植了器官并存活，且这一数字可能会增加。在SOT患者中，痛风是一种常见的合并症，医生应予以关注。本研究表明，与美国普通人群相比，移植受者的痛风发生率明显更高。
