Published online Dec 14, 2026. doi: 10.3748/wjg.122731
Revised: July 30, 2026
Accepted: October 8, 2026
Published online: December 14, 2026
Processing time: 167 Days and 19.7 Hours
It has been reported that the incidence of de novo gastric cancer is significantly increased in solid organ transplantation (SOT) recipients. At least 90% of non-cardia gastric cancers are related to Helicobacter pylori (H. pylori) infection. This article aims to assess the prevalence and sequelae of H. pylori infection in SOT recipients, and to evaluate the efficacy of eradication therapy. A systematic search of the literature was conducted to elucidate the prevalence and impact of H. pylori in SOT recipients and to summarize the outcome of eradication regimens. This study demonstrated an estimated prevalence of H. pylori in SOT recipients of 33%, but the research showed significant heterogeneity, which may be related to the detection methods used. Overall, the prevalence of H. pylori infection in SOT recipients is generally lower than that observed in the general population. Studies indicate that H. pylori infection plays a significant role in the development of gastrointestinal complications, particularly among SOT recipients. However, other studies have found no evidence that H. pylori infection increases the risk of postoperative gastrointestinal complications. Although H. pylori infection is less common in SOT recipients than in the general population, eradication therapy is still advised on diagnosis.
Core Tip: Helicobacter pylori (H. pylori) prevalence among solid organ transplant recipients has decline substantially over the past several years, with contemporary estimates approximating 33%. Notably, pooled analysis suggests a reduced risk of H. pylori infection in transplant recipients compared with non-transplant populations, likely attributable to frequent perioperative antibiotic prophylaxis and routine proton-pump inhibitor use rather than altered susceptibility from immunosuppression. However, given the adverse consequence of H. pylori infection, periodic H. pylori screening and timely eradication with dose-adjusted immunosuppression represent a rational long-term surveillance strategy.