Evaluating a Change in Surgical Antibiotic Prophylaxis in Kidney Transplant Recipients

Bliven, Katherine; Snow, Karisa B.; Carlson, Adrian; Yeager, Sarah; Kenyon, Nicole; Smith, Leslie F.; Truax, Crystal; Martinez, Eryberto; Campsen, Jeffrey

doi:10.7759/cureus.3433

Cited by 2 publications

(2 citation statements)

References 7 publications

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“…Moreover, prophylactic antibiotics may also significantly alter the microbiome ( Jakobsson et al., 2010 ; Korpela et al., 2016 ), confounding investigations into the effect of immunosuppression. Comparisons between cohorts may be complicated by the lack of consensus on optimal perioperative prophylaxis regimes ( Orlando et al., 2015 ; Bliven et al., 2018 ), but such confounders may be avoided by using living organ donors as controls paired with their recipients. However, the effect of factors which solely affect chronic kidney disease patients pre-transplant (specialized diet, uremic toxins) are less easily disentangled from immunosuppression.…”

Section: Use Of Immunosuppressants In Transplantationmentioning

confidence: 99%

Does the Microbiome Affect the Outcome of Renal Transplantation?

Campbell

Humphreys

Summers

et al. 2020

Front. Cell. Infect. Microbiol.

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The role of the human microbiome in health and disease is becoming increasingly apparent. Emerging evidence suggests that the microbiome is affected by solid organ transplantation. Kidney transplantation is the gold standard treatment for End-Stage Renal Disease (ESRD), the advanced stage of Chronic Kidney Disease (CKD). The question of how ESRD and transplantation affect the microbiome and vice versa includes how the microbiome is affected by increased concentrations of toxins such as urea and creatinine (which are elevated in ESRD), whether restoration of renal function following transplantation alters the composition of the microbiome, and the impact of lifelong administration of immunosuppressive drugs on the microbiome. Changes in microbiome composition and activity have been reported in ESRD and in therapeutic immunosuppression, but the effect on the outcome of transplantation is not well-understood. Here, we consider the current evidence that changes in kidney function and immunosuppression following transplantation influence the oral, gut, and urinary microbiomes in kidney transplant patients. The potential for changes in these microbiomes to lead to disease, systemic inflammation, or rejection of the organ itself is discussed, along with the possibility that restoration of kidney function might re-establish orthobiosis.

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Section: Use Of Immunosuppressants In Transplantationmentioning

confidence: 99%

Does the Microbiome Affect the Outcome of Renal Transplantation?

Campbell

Humphreys

Summers

et al. 2020

Front. Cell. Infect. Microbiol.

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“…Immunosuppressant drugs, such as tacrolimus, is a macrolide with antibiotic properties and is therefore likely to affect bacteria. Moreover, prophylactic antibiotics, frequently used in transplant patients, (Orlando et al, 2015;Bliven et al, 2018), may also significantly alter the microbiome (Jakobsson et al, 2010;Korpela et al, 2016;Campbell et al, 2020). The oral microbiome has vital functions in health maintenance and disease protection.…”

Section: Introductionmentioning

confidence: 99%

Transplantation impacts on the oral microbiome of kidney recipients and donors

Campbell,

Willmott,

Humphreys

et al. 2023

Front. Microbiomes

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IntroductionChronic kidney disease (CKD) may affect the human microbiome via increased concentrations of uremic toxins such as urea and creatinine. MethodsWe have profiled the oral microbiota in patients with CKD before and one week after kidney transplantation. Living kidney donors were also longitudinally tracked over a similar period, allowing direct comparison between a group undergoing transplant surgery alone (donors) (n=13) and a group additionally undergoing the introduction of immunosuppressive agents and the resolution of CKD (recipients) (n=45). ResultsTransplantation was associated with a similar pattern of decreasing alpha diversity in the oral microbiome in recipients and donors via Kruskal-Wallis testing, within one week of transplantation. Amplicon sequence variants (ASVs) associated with Haemophilus parainfluenzae, Aggregatibacteria segnis, Peptostreptococcus and Actinobacillus were significantly decreased in recipients within a week of transplantation.DiscussionA reduction in ASVs in these genera could influence the risk of bacterial endocarditis, a rare but high-mortality kidney transplantation complication. A range of factors may drive the observed changes in oral microbiome including both factors associated with surgery itself and the decreases in salivary urea, administration of macrolide antibiotic immunosuppressants, and disruption to immune function that characterise kidney transplant.

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Evaluating a Change in Surgical Antibiotic Prophylaxis in Kidney Transplant Recipients

Cited by 2 publications

References 7 publications

Does the Microbiome Affect the Outcome of Renal Transplantation?

Does the Microbiome Affect the Outcome of Renal Transplantation?

Transplantation impacts on the oral microbiome of kidney recipients and donors

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