The UGI series in renal transplant candidates

We reviewed the charts of 115 renal transplant recipients who had pre-transplant upper gastrointestinal (UGI) barium examinations to assess this examination as a predictor of post-transplant ulceration and hemorrhage. In the past surgical therapy for peptic ulcers was recommended before transplantation because of the risk of life-threatening hemorrhage after transplantation. Peptic ulcer disease was found in 22 patients. Fifteen of these were treated with histamine H2-receptor antagonists and none had ulceration post-transplantation. Three of the seven not so treated had recurrent peptic ulceration. The other 93 examinations were normal. Twelve of the patients with normal examinations developed post-transplant peptic ulceration. We conclude that: (a) the pre-transplant UGI series may not distinguish those patients at risk of UGI ulceration post-transplantation and (b) treatment with H2-receptor antagonists obviates the need for surgical therapy of peptic ulcer disease in these patients before transplantation.