Helicobacter pylori in solid-organ transplant recipient.

PURPOSE OF REVIEW: Helicobacter pylori (H. pylori) infection induces a range of upper gastrointestinal diseases including chronic gastritis, peptic ulcer disease, mucosa-associated lymphatic tissue (MALT) lymphoma, and gastric adenocarcinoma with marked individual variability. In the present review, we survey the published reports on H. pylori infection in organ transplant recipients and summarize findings about the prevalence of H. pylori infection and outcomes such as peptic ulcer and MALT lymphoma induced by H. pylori infection after transplantation.

RECENT FINDINGS: The prevalence of H. pylori infection in solid-organ transplant recipients is similar to that in nontransplant controls, but may be decreased after transplantation. H. pylori infection is associated with peptic ulcer disease and MALT lymphoma after solid-organ transplantation, but the incidence of these diseases does not increase under the immunosuppressive treatment after transplantation. The relationship of H. pylori infection to de-novo gastric cancer after transplantation has not been thoroughly investigated.

SUMMARY: The best management for H. pylori infection in solid-organ transplant recipients has not been established. The association with peptic ulcer disease and MALT lymphoma indicates that H. pylori-positive recipients should be treated for the eradication of H. pylori to avoid upper gastrointestinal diseases after transplantation. However, the efficacy and efficiency of H. pylori eradication therapy before transplantation should be evaluated in future studies.