HELICOBACTER-PYLORI IN RENAL-TRANSPLANT RECIPIENTS

An unselected group of 33 renal transplant recipients were examined by upper gastrointestinal endoscopy at between two and four months after transplantation. All abnormal lesions were documented and biopsied an d, in addition, random biopsies were obtained from the gastric antrum and from the first part of the duodenum. The biopsies were examined an d graded for gastritis and duodenitis and the presence of Helicobacter pylori was noted. Duodenitis was identified in 16 patients and gastri tis in 10; four patients had a gastric ulcer. Helicobacter was identif ied in the gastric antrum of 16 patients (48%) and was strongly associ ated with symptomatic dyspepsia, with gastritis, and with peptic ulcer ation. There was no relationship between H pylori and prednisolone dos e, serum cyclosporine levels, or renal function. H pylori was found to be common in the upper GI tract of renal transplant recipients and ma y explain the high prevalence of upper GI pathology in these patients. It is interesting to speculate that immunosuppression may contribute to this, although there is no direct evidence from this study to suppo rt this theory.