The gut microbiome in solid organ transplantation: from dysbiosis to strain-resolved profiling
The gut microbiome in solid organ transplantation: from dysbiosis to strain-resolved profiling
Solid organ transplantation has saved the lives of people whose organs no longer work properly. However, after transplantation, patients can still develop infections, problems with the transplanted organ, and side effects from the medicines they need to take. The trillions of microorganisms living in our gut, together with the substances they produce, are known as the gut microbiome, which may play an important role in what happens to patients after transplantation. This thesis by Shuyan Zhang investigated how the gut microbiome changes before and after transplantation, and how these changes are associated with medication use and long-term outcomes.
The research showed that the gut microbiome is already unbalanced before lung transplantation and can become further disrupted following transplantation. Medicines that suppress the immune system and antibiotics may contribute to these changes. Importantly, patients with greater disruption of their gut microbiome had a higher risk of death after transplantation.
The research also identified specific kinds of gut bacteria and functions of their genes that were associated with survival after transplantation. In addition, changes in the gut microbiome may affect how tacrolimus, an important medicine used to prevent rejection of the transplanted organ, is processed in the human body. This may partially explain why patients need different doses to achieve the right amount of medicine in their body.
Together, these findings suggest that the gut microbiome may influence long-term outcomes and how medicines are processed after transplantation, potentially contributing to the development of more personalized strategies for long-term transplant care.