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 and, in addition, random biopsies were obtained from the gastric antrum and from the first part of the duodenum. The biopsies were examined and graded for gastritis and duodenitis and the presence of Helicobacter pylori was noted. Duodenitis was identified in 16 patients and gastritis in 10; four patients had a gastric ulcer. Helicobacter was identified in the gastric antrum of 16 patients (48%) and was strongly associated with symptomatic dyspepsia, with gastritis, and with peptic ulceration. There was no relationship between H pylori and prednisolone dose, serum cyclosporine levels, or renal function. H pylori was found to be common in the upper GI tract of renal transplant recipients and may 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 support this theory.