Gut microbiota and allogeneic transplantation

Abstract

The latest high-throughput sequencing technologies show that there are more than 1000 types of microbiota in the human gut. These microbes are not only important to maintain human health, but also closely related to the occurrence and development of various diseases. With the development of transplantation technologies, allogeneic transplantation has become an effective therapy for a variety of end-stage diseases. However, complications after transplantation still restrict its further development. Post-transplantation complications are closely associated with a host’s immune system. There is also an interaction between a person’s gut microbiota and immune system. Recently, animal and human studies have shown that gut microbial populations and diversity are altered after allogeneic transplantations, such as liver transplantation (LT), small bowel transplantation (SBT), kidney transplantation (KT) and hematopoietic stem cell transplantation (HTCT). Moreover, when complications, such as infection, rejection and graft versus host disease (GVHD) occur, gut microbial populations and diversity present a significant dysbiosis. Several animal and clinical studies have demonstrated that taking probiotics and prebiotics can effectively regulate gut microbiota and reduce the incidence of complications after transplantation. However, the role of intestinal decontamination in allogeneic transplantation is controversial. This paper reviews gut microbial status after transplantation and its relationship with complications. The role of intervention methods, including antibiotics, probiotics and prebiotics, in complications after transplantation are also discussed. Further research in this new field needs to determine the definite relationship between gut microbial dysbiosis and complications after transplantation. Additionally, further research examining gut microbial intervention methods to ameliorate complications after transplantation is warranted. A better understanding of the relationship between gut microbiota and complications after allogeneic transplantation may make gut microbiota as a therapeutic target in the future.

Short-Term Intensified Dosage Regimen of Mycophenolic Acid is Associated with Less Acute Rejection in Kidney Transplantation from Donation after Circulatory Death

“…Recent studies showed that gastrointestinal disorders after kidney transplantation were related to intestinal flora disorder [25]; the dosage of MPA might not be the major cause of the gastrointestinal disorder, although a slightly low level of hemoglobin was observed in the intensified group at 1 week after the operation; however, no significant differences were observed at 2 weeks, 1 month, 3 months, and 1 year between the intensified and standard groups. Severe anemia (hemoglobin < 60 g/L) occurred with almost identical frequencies in the 2 groups.…”

Bacterial bloodstream infections in the allogeneic hematopoietic cell transplant patient: new considerations for a persistent nemesis

“…The gut microbiota also influences immune responses by triggering differentiation of T H 17, regulatory and memory T cells and maturation in NKT cells. 135 Disturbances in the microbiome (dysbiosis) are linked to intestinal inflammation and increased prevalence of potentially harmful facultative anaerobic bacteria. 136 During HCT, patients experience dramatic alterations in the intestinal microbiota with marked decreases in overall bacterial diversity, increasing risk for aGvHD and BSI.…”

Fecal microbiota transplantation as a method to treat complications after hematopoietic stem cell transplantation

“…At the level of mesenteric lymph node, one should discuss interaction with innate lymphoid cells via a RORγt nuclear receptor, which reduces local inflammation [29]. Preservation of these interactions allows the growth suppression of pathogenic microbiota, eliminate endogenous and exogenous pathogens, maintain structural integrity of intestinal epithelium.…”