Should Helicobacter pylori infection be treated before kidney transplantation?

Background. Before the introduction of modern medication for ulcer disease. gastroduodenal complications were often fatal in recipients of kidney tran splants. Helicobacter pylori causes gastritis and is an important risk fact or for peptic ulcer disease and gastric malignancies, The aim of this study was to evaluate whether H. pylori infection influences the outcomes of kid ney transplantation. Methods. Between 1991 and 1994, serum H. pylori antibodies were determined in samples taken just before transplantation from 500 consecutive recipient s of kidney transplants. Clinical data were collected retrospectively by me ans of questionnaires sent to the patients and from the national kidney tra nsplantation registry. Results. The prevalence of seropositivity of H. pylori was 31%, in the 500 renal transplant subjects, and the seropositivity increased with age. There were no differences in patient or graft survival between the seronegative and seropositive patients. During the first 3 months after transplantation, five seronegative and one seropositive patient had gastroduodenal ulcers. with bleeding complications in three of the seronegative ones. After 3 mont hs, there were more ulcers in the seropositive group (6 vs 3%) and more oes ophagitis in the seronegative group (9 vs 7%). During the 6-year follow-up, two cases of gastroduodenal malignancies were found in the helicobacter-po sitive group and none in the seronegative group. Conclusions. Helicobacter pylori infections did not result in significant p ostoperative gastric complications. Two of the 155 seropositive patients de veloped gastroduodenal malignancies.