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. 2024 May 20:3:1356058.
doi: 10.3389/frtra.2024.1356058. eCollection 2024.

Meta-analysis and systematic review of gout prevalence in the heart/lung transplantation population

Benedict Chui  1 , Richard Day  1   2 , Eshwar Umashankar  1 , Christina Abdel Shaheed  3   4 , Anne Keogh  1   5 , Laila Girgis #  1   6 , Ross Penglase #  1   6   7
Affiliations

Meta-analysis and systematic review of gout prevalence in the heart/lung transplantation population

Benedict Chui et al. Front Transplant. .

Abstract

Introduction: Gout may complicate solid organ transplantation with potentially serious consequences. An accurate prevalence of gout in this population is unknown.

Objectives: This study aimed to estimate the prevalence of gout in the heart and/or lung transplantation population through a systematic review and meta-analysis.

Methods: MEDLINE, Embase, PsycINFO, CENTRAL and Cochrane Library (inception to February 2022) were searched for studies that reported the prevalence and/or incidence of gout in heart and/or lung transplant recipients. Two authors extracted outcomes data. Data were pooled using a random effects model. Overall quality of evidence was assessed using GRADE. Primary outcomes were the prevalence of pre- or post-transplant gout expressed as a prevalence rate (95% CI). Secondary outcomes included risk factors for gout, adverse events, and therapeutic complications of gout treatment.

Results: Ten studies were included. Gout prevalence (PR) was 8% pre-transplant (PR = 0.08; 95% CI: 0.05-0.12; 4 studies n = 651) and 6% post-transplant (PR = 0.06; 95% CI: 0.06-0.06; 10 studies n = 45,298). Post-transplant gout prevalence in heart transplant recipients was almost three times higher than lung transplant recipients (PR = 0.16; 95% CI: 0.13-0.20 vs. PR = 0.06; 95% CI: 0.05-0.06 respectively). Patients with a pre-transplant history of gout had a higher risk of developing post-transplant gout than patients without (RR = 3.61; 95% CI: 2.19-5.95). Factors associated with gout and outcomes for heart and/or lung transplant recipients with gout were comprehensively reviewed from the included studies.

Conclusion: Gout is highly prevalent in heart and/or lung transplant patients. Pre-transplant gout is predictive of developing symptomatic post-transplant gout. This has significant implications for management of heart/lung transplant patients.

Systematic review registration: https://www.crd.york.ac.uk/, PROSPERO (CRD42020190632).

Keywords: gout; heart transplant (HTx); heart/lung transplant; hyperuricaemia; lung transplant (LTx); uric acid.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Study flow diagram according to PRISMA guidelines.
Figure 2
Figure 2
Pre-transplant prevalence of gout. 95% CI; |: prevalence rate; O: total prevalence rate for each transplant type; ♦: overall prevalence rate.
Figure 3
Figure 3
Post-transplant prevalence of gout. 95% CI; |: prevalence rate; O: total prevalence rate for each transplant type; ♦: overall prevalence rate.
See this image and copyright information in PMC

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