The relevance of intestinal dysbiosis in liver transplant candidates

Grąt, Michał; Hołówko, Wacław; Wronka, Karolina Maria; Grąt, Karolina; Lewandowski, Zbigniew; Kosińska, Irena; Krasnodębski, Maciej; Wasilewicz, Michał; Gałęcka, Mirosława; Szachta, Patrycja; Zborowska, Hanna; Patkowski, Waldemar; Krawczyk, Marek

doi:10.1111/tid.12352

Cited by 19 publications

(21 citation statements)

References 34 publications

(41 reference statements)

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“…investigated LT candidates and revealed that pre-LT dysbiosis was significantly correlated with Enterococcus 36 . Several other studies have also revealed that Enterobacteriaceae and Enterococcus were more abundant in LT candidates with liver cirrhosis than in healthy individuals.…”

Section: Discussionmentioning

confidence: 99%

Gut microbiota of liver transplantation recipients

Sun

Yang

et al. 2017

Sci Rep

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The characteristics of intestinal microbial communities may be affected by changes in the pathophysiology of patients with end-stage liver disease. Here, we focused on the characteristics of intestinal fecal microbial communities in post-liver transplantation (LT) patients in comparison with those in the same individuals pre-LT and in healthy individuals. The fecal microbial communities were analyzed via MiSeq-PE250 sequencing of the V4 region of 16S ribosomal RNA and were then compared between groups. We found that the gut microbiota of patients with severe liver disease who were awaiting LT was significantly different from that of healthy controls, as represented by the first principal component (p = 0.0066). Additionally, the second principal component represented a significant difference in the gut microbiota of patients between pre-LT and post-LT surgery (p = 0.03125). After LT, there was a significant decrease in the abundance of certain microbial species, such as Actinobacillus, Escherichia, and Shigella, and a significant increase in the abundance of other microbial species, such as Micromonosporaceae, Desulfobacterales, the Sarcina genus of Eubacteriaceae, and Akkermansia. Based on KEGG profiles, 15 functional modules were enriched and 21 functional modules were less represented in the post-LT samples compared with the pre-LT samples. Our study demonstrates that fecal microbial communities were significantly altered by LT.

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Section: Discussionmentioning

confidence: 99%

Gut microbiota of liver transplantation recipients

Sun

Yang

et al. 2017

Sci Rep

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“…Intestinal microbial characterization and alteration in early phase and subsequent intestinal barrier dysfunction during acute rejection after LT have been reported [148][149][150][151][152][153]. Due to the high sensitivity of microbial changes during acute rejection after LT, intestinal microbial variation has been suggested to predict acute rejection in the early phase after LT [148].…”

Section: Gut Microbiota and Hepatic Ischemia Reperfusion In Liver Surmentioning

confidence: 99%

Current Knowledge about the Effect of Nutritional Status, Supplemented Nutrition Diet, and Gut Microbiota on Hepatic Ischemia-Reperfusion and Regeneration in Liver Surgery

et al. 2020

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Ischemia-reperfusion (I/R) injury is an unresolved problem in liver resection and transplantation. The preexisting nutritional status related to the gut microbial profile might contribute to primary non-function after surgery. Clinical studies evaluating artificial nutrition in liver resection are limited. The optimal nutritional regimen to support regeneration has not yet been exactly defined. However, overnutrition and specific diet factors are crucial for the nonalcoholic or nonalcoholic steatohepatitis liver diseases. Gut-derived microbial products and the activation of innate immunity system and inflammatory response, leading to exacerbation of I/R injury or impaired regeneration after resection. This review summarizes the role of starvation, supplemented nutrition diet, nutritional status, and alterations in microbiota on hepatic I/R and regeneration. We discuss the most updated effects of nutritional interventions, their ability to alter microbiota, some of the controversies, and the suitability of these interventions as potential therapeutic strategies in hepatic resection and transplantation, overall highlighting the relevance of considering the extended criteria liver grafts in the translational liver surgery.

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“…Enterobacteriaceae species have been reported to be associated with higher MELD scores, whereas the Ruminococcaceae species have been associated with lower MELD scores[ 56 ]. A study of the IM in patients with advanced liver disease revealed that decreased abundance of Bifidobacterium and increased abundance of Enterococcus were associated with increasing liver dysfunction[ 59 ]. The term “cirrhosis dysbiosis ratio” was coined to describe the ratio of autochthonous taxa (taxa that are benign and usually present in the gut such as Ruminococcaceae , Lachnospiraceae , and Clostridiales ) to non-autochthonous ones ( Enterobacteriaceae and Bacteroidaceae ).…”

Section: Characterization Of Im In Cirrhosismentioning

confidence: 99%

Implication of the intestinal microbiome in complications of cirrhosis

Bhat

Arendt

Bhat

et al. 2016

WJH

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The intestinal microbiome (IM) is altered in patients with cirrhosis, and emerging literature suggests that this impacts on the development of complications. The PubMed database was searched from January 2000 to May 2015 for studies and review articles on the composition, pathophysiologic effects and therapeutic modulation of the IM in cirrhosis. The following combination of relevant text words and MeSH terms were used, namely intestinal microbiome, microbiota, or dysbiosis, and cirrhosis, encephalopathy, spontaneous bacterial peritonitis, hepatorenal syndrome, variceal bleeding, hepatopulmonary syndrome, portopulmonary hypertension and hepatocellular carcinoma. The search results were evaluated for pertinence to the subject of IM and cirrhosis, as well as for quality of study design. The IM in cirrhosis is characterized by a decreased proportion of Bacteroides and Lactobacilli, and an increased proportion of Enterobacteriaceae compared to healthy controls. Except for alcoholic cirrhosis, the composition of the IM in cirrhosis is not affected by the etiology of the liver disease. The percentage of Enterobacteriaceae increases with worsening liver disease severity and decompensation and is associated with bacteremia, spontaneous bacterial peritonitis and hepatic encephalopathy. Lactulose, rifaximin and Lactobacillus-containing probiotics have been shown to partially reverse the cirrhosis associated enteric dysbiosis, in conjunction with improvement in encephalopathy. The IM is altered in cirrhosis, and this may contribute to the development of complications associated with end-stage liver disease. Therapies such as lactulose, rifaximin and probiotics may, at least partially, reverse the cirrhosis-associated changes in the IM. This, in turn, may prevent or alleviate the severity of complications.

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The relevance of intestinal dysbiosis in liver transplant candidates

Cited by 19 publications

References 34 publications

Gut microbiota of liver transplantation recipients

Gut microbiota of liver transplantation recipients

Current Knowledge about the Effect of Nutritional Status, Supplemented Nutrition Diet, and Gut Microbiota on Hepatic Ischemia-Reperfusion and Regeneration in Liver Surgery

Implication of the intestinal microbiome in complications of cirrhosis

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