Helicobacter Pylori Infection in Renal Transplant Patients

Study Overview
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Brief Summary
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Upper gastrointestinal (GI) symptoms are frequent in organ transplant recipients. Peptic ulcers and related pathologies such as gastritis and duodenitis are known to occur with increased frequency (20-60%) and severity in renal transplant recipients. The frequency of severe complications is about 10% among transplant recipients and 10% of those might prove fatal As kidney transplant recipients have to take immunosuppressive drugs for a lifetime and because these drugs have many side effects that may not be differentiated from H. pylori infection Thus, in order to reduce the use of medications and subsequently to reduce the drug interactions ,proper detection and management of H pylori infection in those patients is preferred.

Detailed Description
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The prevalence of HP colonization is about 30% in the United States and other developed countries as opposed to more than 80% in most developing countries. Essentially, all HP-colonized persons have gastric inflammation, but this condition in itself is asymptomatic. Upper gastrointestinal (GI) symptoms are frequent in organ transplant recipients. Peptic ulcers and related pathologies such as gastritis and duodenitis are known to occur with increased frequency (20-60%) and severity in renal transplant recipients. The frequency of severe complications is about 10% among transplant recipients and 10% of those might prove fatal. GI complications might require dose reduction or the discontinuation of some of the immunosuppressive medications, affecting graft survival. Considering the strong body of evidence supporting causal effects of HP infections on the development of peptic ulcers and gastric malignancies, the argumented rate of gastrointestinal complaints may bebattributed to increased HP infection rate among this population. Few studies have investigated the prevalence of HP infection; about 30% to 40% of renal transplant recipients shown HP colonization of the stomach There are conflicting data about the prevalence of H pylori infection in renal transplant recipients. Most of these studies used anti HP IgG to diagnose H. pylori infection that lack consistent sensitivity and specificity. Nasri and his colleagues in 2013 concluded significant positive association of serum H. Pylori IgG antibody titer with renal function in renal transplant patient. As kidney transplant recipients have to take immunosuppressive drugs for a lifetime and because these drugs have many side effects that may not be differentiated from H. pylori infection Thus, in order to reduce the use of medications and subsequently to reduce the drug interactions ,proper detection and management of H pylori infection in those patients is preferred. There are few studies have investigated the prevalence of HP infection; about 30% to 40% of renal transplant recipients shown HP colonization of the stomach. There are conflicting data about the prevalence of H pylori infection in renal transplant recipients.

Official Title
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Helicobacter Pylori Infection in Renal Transplant Patients

Conditions
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Helicobacter Pylori Infection, Renal Transplant Infection

Intervention / Treatment
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* Diagnostic Test: H pylori Faecal Antigen


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age ≥ 18 years. Patients in the first 1st. year after kidney transplantation. Patients diagnosed to have H.pylori infection by H.pylori fecal Ag will do endoscopy and biopsy. Exclusion Criteria: Patients who had previous upper endoscopy with evidence of gastritis or ulcers Age more than 65 years old Patients with any contraindications to upper endoscopy.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Diagnostic Test: H pylori Faecal Antigen|All patients will be screened for H. pylori using fecal Ag and positive patients will do endoscopy and biopsy.|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Prevalence of H pylori post Renal Transplant Patients | Percentage of H pylori positive patients in post renal transplant patients | 1 year | 
| Detection of CagA & VacA Genotypes by PCR: | Amplified DNA will be analyzed by agarose gel electrophoresis. The positive sample will produce bands at DNA fragment 138-bp for CagA, 259/286-bp for VacA S1/S2, 290-bp and 352-bp for m1 & m2, respectively. | 1 year |