Gut microbiota might influence the risk of rejection after liver transplantation

Abstract

IntroductionLiver transplantation is the only radical treatment option available for patients with end-stage chronic liver disease. However, severe post-transplant complications remain relevant, including acute graft rejection and infection. Thus, the impact of gut microbiota on the frequency of these complications is highly promising. Materials and methodsThis prospective, cohort, closed-label study included 24 adults who underwent liver transplantation. The mean age was 49.2 ± 13.4 years; Child-Turcotte-Pugh A, B, and C classes were distributed as follows: A: 8 (33.3%); B: 11 (45.8%); C: 5 (20.8%). Gut microbiota was evaluated using 16S RNA new-generation sequencing. Study registrationNCT04281797. ResultsAccording to etiological distribution, significant differences were observed in the number of Firmicutes (p = 0.03) and Chlorobi (p = 0.009) harbored by the patients of alcoholic liver disease. Similarly, the severity of hepatic decompensation varied significantly for patients harboring Chlorobi (p = 0.01) and coprothermobacterota (p = 0.03). The association between sarcopenia and the microbiota was not significant among all taxa (p>0.1). Acute graft rejection differences between groups were found: Protobacteria (p = 0.001); Chlamydiae (p = 0.02); Gammaproteobacteria (p = 0.01); Chloroflexia (p = 0.004); Chlamydiia (p = 0.01); Enterobacteriaceae (p = 0.001); and Candidatus Saccharibacteria (p = 0.04), the median of which was found to be lower in patients with an acute graft rejection episode. ConclusionsObtained results prove a reliable interaction between gut microbiota and the incidence of acute liver graft rejection in dominant taxa and Candidatus Saccharibacteria that had not yet been observed in patients with rejection episodes.