Respiratory Diseases and Lung Transplantation, Department of Medical and Surgical Sciences & Neurosciences, University of Siena, Viale Bracci, 16, 53100, Siena, Italy.
Thoracic Surgery, Department of Medical and Surgical Sciences & Neurosciences, University of Siena, Siena, Italy.
Lung. 2019 Feb;197(1):95-99. doi: 10.1007/s00408-018-0178-7. Epub 2018 Nov 19.
Helicobacter pylori (HP) is a spiral, gram-negative, microaerophilic bacterium that colonises the human gastric mucosa and is associated with gastrointestinal and extragastrointestinal disorders. Since no data are yet available on HP infection in lung transplant patients, we evaluated the prevalence and impact of HP infection in a population of such patients.
Sixty-seven lung transplant patients were enrolled in the study (35 females and 32 males, age 48.4 ± 13.3 years), 54 underwent bilateral and 13 single lung transplant. Serum antibodies against HP and CagA were assayed in all subjects.
The prevalence of HP infection in lung transplant patients was similar to that in the general population (49.25% vs. 51.4%), whereas HP-positive patients showed lower CagA positivity (9% vs. 50.2%, p < 0.0001). There was a higher prevalence of HP infection in patients who underwent lung transplant because of pulmonary fibrosis (p = 0.049), and a lower prevalence in COPD patients (p = 0.011). No correlation was found between HP infection in lung transplant patients and graft outcome. No differences in primary graft dysfunction, acute rejection or bronchiolitis obliterans syndrome-free survival were found. However, more patients who required three or more post-transplant re-hospitalisations were observed among HP-positive patients.
The prevalence of HP infection in lung transplant patients was comparable to that of the general population and to that reported in heart and kidney transplant recipients. It did not seem to impact short-, mid- or long-term lung allograft outcome. H. pylori infection did not prove to be clinically relevant in lung transplant patients.
幽门螺杆菌(HP)是一种螺旋形、革兰氏阴性、微需氧细菌,定植于人类胃黏膜,与胃肠道和胃肠外疾病有关。由于目前尚无关于肺移植患者 HP 感染的数据,我们评估了该人群中 HP 感染的流行率和影响。
本研究纳入了 67 例肺移植患者(35 名女性和 32 名男性,年龄 48.4±13.3 岁),54 例接受了双肺移植,13 例接受了单肺移植。所有患者均检测血清抗 HP 和 CagA 抗体。
肺移植患者的 HP 感染率与普通人群相似(49.25% vs. 51.4%),但 HP 阳性患者的 CagA 阳性率较低(9% vs. 50.2%,p<0.0001)。因肺纤维化而接受肺移植的患者中 HP 感染的发生率较高(p=0.049),而 COPD 患者的发生率较低(p=0.011)。在肺移植患者中,HP 感染与移植物结局之间没有相关性。未发现原发性移植物功能障碍、急性排斥反应或闭塞性细支气管炎综合征无生存差异。然而,在 HP 阳性患者中,更多的患者需要三次或更多次移植后住院治疗。
肺移植患者的 HP 感染流行率与普通人群和心脏、肾脏移植受者相似。它似乎没有影响短期、中期或长期肺移植物的结局。HP 感染在肺移植患者中并不具有临床意义。