SEROPOSITIVITY FOR H. PYLORI IN CHILDREN WITH LIVER TRANSPLANTS

Abstract

Helicobacter pylori (H. pylori) is strongly associated with gastritis and peptic ulcer disease and is acquired during childhood. The role of H. pylori in children with liver transplants is unknown. AIM: To determine the prevalence of H. pylori IgG seropositivity in children before and after liver transplantation. METHODS: Paired sera before and after liver transplant from 19 children (mean age 2.6 yr., range: 3 mos.-14 yr.; 1 boy, 18 girls) between 1989-1996 were available for testing for H. pylori IgG using an immunochromatographic method (Flexsure HP, SmithKline Diagnostics, Inc., Palo Alto, CA). Indications for transplant included: biliary atresia (12), tyrosinemia (2), alpha-1-antitrypsin deficiency (1), autoimmune hepatitis (1), cryptogenic cirrhosis (2), hepatic tumor (1). The children's races were: Caucasian (12), Asian (3), Hispanic (2), Black (1) and Native American (1). RESULTS: Pre-transplant, 3/19 (16%) of the children were seropositive, similar to the reported incidence of H. pylori seropositivity in healthy children (14%). Post-transplant, an additional 5/19 (26%) of the children became seropositive. The overall seropositivity rate was 8/19 (42%) in these liver transplant children. The difference in seropositivity rates between healthy children and liver transplant children is highly significant (p=0.01). There was no association between H. pylori seropositivity and race. CONCLUSIONS: The seropositivity rate for H. pylori in children with liver transplants is high. This may have major clinical and therapeutic implications in the management of liver transplant children. A prospective study of H. pylori seropositivity, conversion rate and clinical outcomes in children with liver transplants is warranted based upon the results of this preliminary study.