Background/Purpose: Although incidence and survival are frequent topics within the solid organ transplant (SOT) literature, there are no recent publications on the total size of the surviving SOT population. Existing studies of gout in 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.

Methods: 2017 U.S. population sizes of kidney, heart, liver, and lung recipients were estimated by combining Organ Procurement and Transplantation Network (OPTN) primary transplant cohort sizes (1988-2017) with previously published survival rates for each annual cohort’s time since transplant (0-29 yrs), adjusted for recent improvements in 1-5 yr survival. Gout among prevalent SOT patients was assessed via 2 administrative claims databases: Medicare Fee-For-Service Limited Data Set (5% sample) and a commercial claims sample (IQVIA^TM Real-World Data Adjudicated Claims – US). Definitions used were – SOT: a claim with an SOT procedure code OR any claim with a history of SOT status code; Gout: ≥1 claim with any gout diagnosis code. Total gout prevalence was calculated by weighting Medicare and commercially insured patient estimates by OPTN payer distribution.

Results: 637,231 U.S. patients received a primary kidney (393,953), liver (142,186), heart (66,637), or lung (34,455) transplant between 1988 and 2017. An estimated 355,000 (55.8%) recipients were alive in 2017, comprising 233,000 kidney, 78,700 liver, 29,300 heart, and 14,700 lung recipients. Gout was identified in 11% of prevalent SOT patients in 2016. Higher rates of gout were seen in kidney (13%) and heart (13%) recipients compared to liver (6.4%) and lung (5.3%) recipients (p<0.0001 in both datasets).

Conclusion: Hundreds of thousands of U.S. patients are living with an organ transplant today and these numbers are likely to increase. Within the SOT clinical picture, gout is a frequent co-morbidity of which physicians should be aware. This study suggests a markedly higher rate of gout for the most common SOT types (11%) compared to established rates reported for the general population (e.g. 3.9%). Kidney and heart recipients, with the highest rates of gout, bear much of this disease burden.