Risk of death after organ transplantation associated with abnormal gut flora

Risk of death after organ transplantation associated with abnormal gut flora
Risk of death after organ transplantation associated with abnormal gut flora

This is apparent from a large, long-term study by researchers from the UMCG

The gut flora (also called microbiome) of patients who have had a kidney or liver transplant is less diverse after transplantation than in the general population. This change in gut microbiota is associated with poorer health status and a greater risk of death for these groups of patients. Also, the composition of their gut flora differs greatly from the general population.

This is apparent from a large, long-term study by researchers from the UMCG. In this study they used health data from the TransplantLines and Lifelines biobanks. The results, published today in Science Translational Medicine, provide a starting point for developing possible treatments that protect the gut flora of transplant patients and thus improve their quality of life and general health.

Role of microbiome in organ transplantation still unknown
Organ transplantation is a life-saving treatment for many patients. Due to advancing insights and techniques, the chance of survival after a transplant is still increasing. As a result, there is now also more attention for the quality of life of patients after a transplant, because there is still room for improvement in this area. Nevertheless, the survival chances of transplant patients still vary greatly due to rejection and infections after organ transplantation. It is known that the intestinal flora has an important relationship with the immune system. But until now, little was known about the role of the microbiome in organ transplants and the immunosuppressive drugs involved. Through a collaboration between the Groningen Transplantation Center and the microbiome researchers of the UMCG, more has now become clear for the first time about the influence of the microbiome on two groups of transplant patients.

Long-term study in kidney and liver transplant patients
The researchers analyzed a total of 1,370 stool samples from 415 liver transplant recipients and 672 kidney transplant recipients. They did the same with 1183 samples of the participants from the general population of LifeLines who were comparable in age, gender and weight to the transplant patients. In addition, they followed 78 kidney transplant recipients for an extended period of time prior to transplantation up to 24 months after transplantation. They obtained this health data from the TransplantLines biobank, in which data from transplant patients in the UMCG are kept and used for research to improve the quality of life of these patients.

Difference in composition of intestinal flora before and after transplantation
The research shows that the composition of the microbiome of both kidney and liver transplant patients is clearly different after their transplant than before the transplant. The composition also differs from that of the general population. There is an increase in unhealthy bacteria and a decrease in bacteria that are known to have a positive function on health. These changes were found to persist for up to 20 years after transplantation.

Difference in intestinal flora composition can be partly explained by immune-suppressing medication
After transplantation, the composition of their intestinal flora appears to be less diverse. The research also shows that more unhealthy intestinal flora is present in transplant patients and that important aspects of the bacterial metabolism function less well. All of these factors can be partly explained by the use of the immunosuppressive medication that all transplant patients must take to prevent rejection of the donor organ. As a result, they also need antibiotics more often for an infection and this can also change the composition of the intestinal flora.

Difference in gut flora associated with risk of death
Finally, the research shows that the less diverse intestinal flora after transplantation is associated with poorer health and a higher risk of death for these groups of patients. The researchers concluded that the difference in gut flora between transplant patients and healthy people is related to the risk of death. The more the gut flora of transplant patients deviates from the gut flora of people from the general population, the greater the chance of death.

Potential microbiome-targeted treatment for transplant patients
According to the researchers, this study is a first step towards potential microbiome-targeted treatments in transplant patients. These treatments should lead to a positive change in the composition of the intestinal flora or to protect them against the drugs they have to use. This is expected to improve their overall health and potentially improve their quality of life. In addition, this study contributes to understanding the relationship between the microbiome and the immune system.

First publication from important collaboration
This publication in Science Translational Medicine is the first to arise from the collaboration between the TransplantLines Biobank and the Groningen Microbiome Hub of the UMCG. They are also currently conducting research into the importance of the microbiome on the health of other groups of transplant patients.

The research was made possible in part by a subsidy from the NWO/TTW/DSM partnership program Animal Nutrition and Health.

The publication in Science Translational Medicine can be found here.

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The article is in Dutch

Tags: Risk death organ transplantation abnormal gut flora

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