SEROEPIDEMIOLOGY OF HELICOBACTER-PYLORI INFECTION IN HEART-TRANSPLANTRECIPIENTS

We analyzed serum samples obtained from 100 heart transplant recipient s before and after transplantation for the presence of IgG antibodies to Helicobacter pylori. Enzyme-linked immunosorbent assay revealed tha t 35 patients were seropositive before the procedure. Seropositive pat ients were older than seronegative patients, but the two groups did no t differ in terms of cardiac diagnosis, gender, survival, or the numbe r of admissions or rejection episodes. In addition, seropositive patie nts did not have more-frequent episodes of gastritis, ulcer disease, o r gastrointestinal bleeding. Over a mean serological follow-up of 3.4 years, only one of 65 seronegative patients seroconverted. Of the 35 s eropositive patients, 14 became seronegative for H. pylori a median of 194 days (range, 47-2,657 days) after transplantation. Seroreverters, as compared with serofast patients, had received more intravenous and total antibiotics during follow-up (P = .01), were more likely to hav e received a combination of antibiotics active against H. pylori (P < .025), and had received more antirejection treatment (P = .01). The in cidence of H. pylori infection is not increased after heart transplant ation, and many seropositive patients serorevert after transplantation when antibacterial and immunosuppressive agents are administered.