The Clinical Impact of Helicobater pylori Infectionin Pre and Post-kidney Transplant Recipients

Yang, Chul Woo; Kim, Yong Soo; Kim, Suk Young; Choi, Euy Jin; Chang, Yoon Sik; Bang, Byung Kee; Kim, Byung Su; Lee, Myung Ah; Park, Joo Hyun; Lee, Seung Heon

Abstract

Helicobacter pylori(H. pylori) is thought to play an important role in the pathogenesis of peptic ulcer. Because peptic ulcer is one of serious complications during renal transplantation, we evaluated the inci- dence and clinical impact of H. pylori infection in pre-KT and post-KT recipients. Gastrofiberscopy was performed in 179 kidney transplant recipients(M: F=124: 55) at Kangnam St. Mary's Hospital from Aug. 1994 to Mar. 1998 preoperatively and was followed up postoperatively 14 days. Diagnosis of H. pylori infection was made by Warthin Starry stain on biopsy specimen. H2 blocker, antacids and misoprostol were prescribed to all patients from preoperative 7 days. Preoperative eradication of H. pylori infection was not performed. In pre-KT patietns, gastrofiberscopy showed normal(0.6M), gastritis(82.79%), gastric ulcer(6.7%), duodenitis(5.6%), esophagitis(3.9%) and duodenal ulcer(0.6%). In post-KT recipients, gastrofiberscopic findings were normal(1.7%), gastritis(83.8%), gastric ulcer(7.3%), duodenal ulcer(2.8%), esophagitis(2.2%) and duodenitis(2.2%). The incidence of H. pylori infection in pre-KT patients and post-KT recipients was 27.9% and 13.4 96, respectively(p<0.001). In pre-KT patients, peptic ulcer has occurred more often in patients with H. pylori infection(p<0.01). In post-KT recipients, peptic ulcer was not correlated with H. pylori infection. H. pylori infection did not affect renal function and the incidence of acute rejection and was not affected by cyclosporine blood level, accumulated doses of prednisolone or use of methylprednisoloe in renal transplant recipients. In conclusion, the incidence of H. pylori infection is higher in pre-KT recipients than that in post-KT recipients. This may be due to drugs such as antibiotics used during renal transplantation. And H. pylori infection does not seem to be a major cause of peptic ulcer in renal transplantation. We think other causes including drugs and stress may develop peptic ulcer in renal transplantation but further evaluation will be necessary.