Characteristics of fecal microbial communities in patients with non-anastomotic biliary strictures after liver transplantation

Abstract

AIMTo explore the possible relationship between fecal microbial communities and non-anastomotic stricture (NAS) after liver transplantation (LT).METHODSA total of 30 subjects including 10 patients with NAS, 10 patients with no complications after LT, and 10 non-LT healthy individuals were enrolled. Fecal microbial communities were assessed by the 16S rRNA gene sequencing technology.RESULTSDifferent from the uncomplicated and healthy groups, unbalanced fecal bacterium ratio existed in patients with NAS after LT. The results showed that NAS patients were associated with a decrease of Firmicutes and Bacteroidetes and an increase of Proteobacteria at the phylum level, with the proportion-ratio imbalance between potential pathogenic families including Enterococcaceae, Streptococcaceae, Enterobacteriaceae, Pseudomonadaceae and dominant families including Bacteroidaceae.CONCLUSIONThe compositional shifts of the increase of potential pathogenic bacteria as well as the decrease of dominant bacteria might contribute to the incidence of NAS.

Enteric dysbiosis in liver and kidney transplant recipients: a systematic review

“…An analysis (Table 4) shows the predominant microorganisms as well as diversity comparisons of the pre‐ and the post‐transplant microbiome from liver and kidney studies. There was an overall decrease in microbial diversity post‐transplant as compared to the pre‐transplant state [25,28,30,31]. Additionally, an increase in the relative abundance of pathogenic microorganisms, belonging to the phyla Proteobacteria and Actinobacteria , was noted with antibiotic use despite the decrease in overall diversity.…”

“…[31] revealed a significant reduction in the SDI from an interquartile range of 3–5 pre‐transplant to 2–5 at 1 month post‐transplant. However, the microbial diversity at 15–21 months post‐transplant is still lower when compared to healthy controls [30].…”

“…Table 1 provides quality scores for the studies, assessing risk of bias. In total, nine studies were of good quality [23][24][25][26][27][28][29][30][31], three studies were of fair quality [32][33][34], and one was of poor quality [35]. The main concerns were outcome (lack of adequate follow-up) and comparability.…”

“…Even though microbial diversity improves with time after SOT, Zhang et al . [30] still found the microbiome at 15–21 months post‐transplant to be less diverse than healthy controls. The dissimilarity in the microbial diversity may be due to the difference in analysis timing; for example, Bajaj et al .…”

“…Particularly, Enterobacteriaceae enrichment was associated with endotoxemia, increased intestinal permeability, and liver-related diseases [45,46]. Other pathogenic families such as Enterococcaceae, Streptococcaceae, and Pseudomonodaceae were reported to be associated with non-anastomotic biliary strictures post-LT [30]. More specifically, Enterococcaceae was reported to be abundant in children with Crohn's disease treated with Infliximab and insulin-using cirrhotic patients [47,48].…”