Effects of continuous use of probiotics before liver transplantation: A randomized, double-blind, placebo-controlled trial

Grąt, Michał; Wronka, Karolina Maria; Lewandowski, Zbigniew; Grąt, Karolina; Krasnodębski, Maciej; Stypułkowski, Jan; Hołówko, Wacław; Masior, Łukasz; Kosińska, Irena; Wasilewicz, Michał; Raszeja‐Wyszomirska, Joanna; Rejowski, Sławomir; Bik, Emil; Patkowski, Waldemar; Krawczyk, Marek

doi:10.1016/j.clnu.2017.04.021

Cited by 61 publications

(96 citation statements)

References 40 publications

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“…Lactobacillus was a component of each of the probiotic products used in the preventative literature. No cases of infection due to probiotic‐derived bacteria occurred in these studies …”

Section: Safetymentioning

confidence: 74%

“…The infection preventive effects of probiotics in human subjects undergoing LTX have been investigated in six clinical studies with fairly rigorous methodology, including prospective randomization, blinding, and placebo control (Table ) . Overall findings have supported the use of probiotics as an infection preventative strategy.…”

Section: Efficacymentioning

confidence: 96%

“…Finally, in a double‐blind, placebo‐controlled, randomized controlled trial, a total of 55 LTX patients were randomized to receive either placebo or a probiotic prior to transplantation . The probiotic utilized in the study contained four bacterial strains ( Lactobacillus lactis, L. casei, L. acidophilus, and Bifidobacterium bifidum ).…”

Section: Efficacymentioning

confidence: 99%

“…The isolate was cultured from peritoneal fluid. No information regarding probiotic use or yogurt ingestion was available, and the study period predated the publication of the aforementioned infective preventative literature . Of note, Saccharomyces sp were not a component of any of the probiotic products in any of the available efficacy literature in LTX recipients…”

Section: Safetymentioning

confidence: 99%

“…In general, minor gastrointestinal side effects are the main adverse drug events reported with probiotics and synbiotics including abdominal distention, nausea, cramps, gas, and diarrhea . However, probiotics are frequently given to patients to improve these complaints, so there is the potential for confounding disease processes.…”

Section: Safetymentioning

confidence: 99%

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Efficacy and Safety of Probiotics and Synbiotics in Liver Transplantation

et al. 2018

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This article summarizes available literature regarding the utilization of probiotic and synbiotics in liver transplant (LTX) recipients, reviewing efficacy in both decreasing infectious complications and immunomodulation, as well as exploring safety concerns. Data suggest that the use of probiotics containing Lactobacillus spp, either alone or in combination with prebiotics (referred to as synbiotics), may be effective in reducing infectious complications after LTX, a major contributor to graft loss, hospital length of stay, and mortality. Literature evaluating the use of probiotics to induce tolerance, reduce rejection, and prevent damage associated with ischemia-reperfusion injury is limited to animal models but compelling, as it suggests the use of probiotics may augment deleterious immune-mediated processes in this population. While the benefits of probiotics should be weighed against potential risks, these concerns are largely theoretical in the LTX recipient, with the majority of evidence extrapolated from case reports in other immunosuppressed populations. Based on available literature, it may be prudent to avoid products containing Saccharomyces sp, as these were not used in the efficacy studies, and the majority of the adverse event reporting stems from the use of products containing this organism. Further evaluation of the safety and efficacy of probiotic therapy is warranted. Studies specifically designed to elucidate the optimal product and initiation scenario and delineate safety in this population are needed to allow expanded use of this inexpensive, relatively nontoxic, and potentially beneficial therapeutic option after LTX.

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“…Lactobacillus was a component of each of the probiotic products used in the preventative literature. No cases of infection due to probiotic‐derived bacteria occurred in these studies …”

Section: Safetymentioning

confidence: 74%

Section: Efficacymentioning

confidence: 96%

Section: Efficacymentioning

confidence: 99%

Section: Safetymentioning

confidence: 99%

Section: Safetymentioning

confidence: 99%

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