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Nephrol Dial Transplant (2001) 16: 2053-2057
© 2001 European Renal Association-European Dialysis and Transplant Association

Should Helicobacter pylori infection be treated before kidney transplantation?

Susanna Sarkio1,, Hilpi Rautelin2, Lauri Kyllönen1, Eero Honkanen3, Kaija Salmela1 and Leena Halme1

1 Transplantation and Liver Surgery, Helsinki University Hospital, 2 Department of Bacteriology and Immunology, Haartman Institute, University of Helsinki and Helsinki University Hospital Diagnostics and 3 Department of Internal Medicine, Division of Nephrology, Helsinki University Hospital, Helsinki, Finland

Background. Before the introduction of modern medication for ulcer disease, gastroduodenal complications were often fatal in recipients of kidney transplants. Helicobacter pylori causes gastritis and is an important risk factor for peptic ulcer disease and gastric malignancies. The aim of this study was to evaluate whether H. pylori infection influences the outcomes of kidney transplantation.

Methods. Between 1991 and 1994, serum H. pylori antibodies were determined in samples taken just before transplantation from 500 consecutive recipients of kidney transplants. Clinical data were collected retrospectively by means of questionnaires sent to the patients and from the national kidney transplantation 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 months, there were more ulcers in the seropositive group (6 vs 3%) and more oesophagitis in the seronegative group (9 vs 7%). During the 6-year follow-up, two cases of gastroduodenal malignancies were found in the helicobacter-positive group and none in the seronegative group.

Conclusions. Helicobacter pylori infections did not result in significant postoperative gastric complications. Two of the 155 seropositive patients developed gastroduodenal malignancies.

Keywords: Helicobacter pylori; kidney transplantation; malignancy; ulcer

Correspondence and offprint requests to: Susanna Sarkio MD, Transplantation and Liver Surgery, Helsinki University Hospital, PL 263, FIN-00029 HUS Helsinki, Finland. Email: susanna.sarkio{at}fimnet.fi


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