HELICOBACTER-PYLORI IN KIDNEY ALLOGRAFT RECIPIENTS - HIGH PREVALENCE OF COLONIZATION AND LOW INCIDENCE OF ACTIVE INFLAMMATORY LESIONS

Since kidney transplant recipients are at enhanced risk for developing severe upper gastrointestinal disease and Helicobacter pylori (Hp) is an important pathogen in active gastritis and peptic ulcer, we perfor med gastroduodenoscopic examination, coupled with assessment of Hp col onization in 29 renal allograft recipients complaining of recurrent dy spepsia. Results were compared with those of 25 chronically hemodialyz ed patients and 16 subjects free from renal disease, also suffering fr om upper gastrointestinal symptoms of similar severity. We found that while transplant recipients have had a high prevalence of Hp infection (62 vs. 34.6% in dialysis and 43.6% in control dyspeptic patients), a ctive gastritis was clearly less frequently seen in these patients tha n in control subjects (transplant group: 6.9%, dialysis 3.8%, control 31.3%) and peptic ulceration was totally absent. Prevalence of Hp colo nization was even higher in renal graft recipients on triple posttrans plant immunosuppression (82%). In dyspeptic transplant and dialysis pa tients, colonization with Hp did not account for development of active inflammatory lesions, an association frequently seen in subjects free from renal disease and immunosuppressive therapy.