Chronological changes in the gut microbiota and intestinal environment in recipients and donors of living donor liver transplantation

• Published in: Journal of hepato-biliary-pancreatic sciences Vol. 30; no. 4; pp. 439 - 452
• Main Authors: Yao, Siyuan, Yagi, Shintaro, Hirata, Masaaki, Miyachi, Yosuke, Ogawa, Eri, Uozumi, Ryuji, Sugimoto, Takuya, Asahara, Takashi, Uemoto, Shinji, Hatano, Etsuro
• Format: Journal Article
• Language: English
• Published: Japan Wiley Subscription Services, Inc 01-04-2023
• Subjects: dysbiosis; End Stage Liver Disease - surgery; fecal organic acid; Gastrointestinal Microbiome; Humans; Liver Transplantation; Liver transplants; Living Donors; Microbiota; predominant obligate anaerobes; Prospective Studies; reverse‐transcription quantitative polymerase chain reaction; Severity of Illness Index; short‐chain fatty acid; fecal organic acid; reverse-transcription quantitative polymerase chain reaction; short-chain fatty acid; predominant obligate anaerobes; dysbiosis
• ISSN: 1868-6974; 1868-6982
• DOI: 10.1002/jhbp.1241

Background/Purpose
This prospective study aimed to investigate the dynamic changes in the gut microbiota (GM) and associated intestinal environment, which were assessed by measuring fecal organic acid (OA) concentrations, during the early period after liver transplantation (LT). To understand the fundamental characteristics of the human GM, data obtained from living donors were also analyzed.
Methods
Fixed‐point observation was performed in 23 recipients and 21 donors for up to 2 weeks after LT. The GM and OA concentrations were investigated using ribosomal RNA‐targeted reverse‐transcription quantitative polymerase chain reaction and high‐performance liquid chromatography, respectively.
Results
Before LT, the recipients exhibited remarkable dysbiosis and OA depletion, which were proportional to the model for end‐stage liver disease score. Correlations between the abundances of some specific strains and OA concentrations were observed. After LT, while donor lobectomy caused only slight, transient and reversible changes in the GM and OA concentrations, recipients exhibited delayed recovery in these factors. However, no clear evidence of causality was observed between the GM or OA concentrations and LT outcomes.
Conclusions
The GM and intestinal environment in LT recipients exhibited characteristics that were clearly different from those in donors. LT did not normalize but rather disrupted the GM during the early post‐LT period, but its negative clinical impact could be minimized with perioperative management.
Yao and colleagues investigated alterations in the gut microbiota and fecal organic acid concentrations in both recipients and donors during the peri‐liver transplant period. In the recipients, statuses were more disrupted during the first 2 weeks after transplantation than before transplantation, while in the donors, hepatectomy caused only slight reversible alterations.