Characteristics of the gastrointestinal microbiota in paired live kidney donors and recipients

Abstract

Background There are few studies that have examined whether dysbiosis occurs in kidney donors and transplant recipients following kidney transplant surgery. Aim To ascertain whether changes occur in the gastrointestinal microbiota of the kidney donor and recipient following kidney transplantation. Methods Kidney transplant recipients and their donors were prospectively enrolled in a pilot study to collect one faecal sample prior to, and another faecal sample between four to eight weeks following surgery. Gastrointestinal microbiota richness, Shannon diversity measures and functional assessments of kidney donors and recipients were analysed via metagenomic sequencing. Results The study included 12 donors (median age 56 years, 6 females) and 12 recipients (median age 51 years, 3 females). Donor microbiota showed no significant changes in gastrointestinal microbiota richness, Shannon diversity, or functional assessments before and after nephrectomy. Recipient microbiota was altered post‐transplant, reflected in reductions of the mean (±SD) richness values (156 ± 46.5 to 116 ± 38.6, p = 0.002), and Shannon diversity (3.57 ± 0.49 to 3.14 ± 0.52, p = 0.007), and a dramatic increase in Roseburia spp. abundance post‐transplant (26‐fold increase from 0.16 ± 0.0091 to 4.6 ± 0.3; p = 0.006; FDR = 0.12). Functionally, the post‐transplant microbial community shifted towards those taxa using the glycolysis pathway (1.2‐fold increase; p = 0.02; FDR = 0.26) for energy metabolism, while those functions involved with reactive oxygen species degradation decreased (2.6‐fold; p = 0.006; FDR = 0.14). Conclusion Live donor kidney transplantation and standard care post‐transplant result in significant alterations in gut microbiota richness, diversity, composition and functional parameters in kidney transplant recipients but not in their kidney donors.

Regulation of gut microbiota: a novel pretreatment for complications in patients who have undergone kidney transplantation

“…(2018) reported a decrease in Firmicutes abundance instead of an increase in recipients of kidney transplants ( Guirong et al., 2018 ). Chan et al. (2021) classified Firmicutes into two types and reported a significantly greater abundance of Firmicutes A and a relatively lower abundance of Firmicutes G ( Chan et al., 2021 ).…”

“… Chan et al. (2021) classified Firmicutes into two types and reported a significantly greater abundance of Firmicutes A and a relatively lower abundance of Firmicutes G ( Chan et al., 2021 ). This may explain the contradictory results reported by different studies.…”

Prebiotic Supplementation in Kidney Transplant Recipients for Preventing Infections and Gastrointestinal Upset: A Randomized Controlled Feasibility Study

“…3 The increase in gastrointestinal symptoms may be due to a range of factors including donor-derived infections, immunosuppressive therapy, nosocomial infections, and perioperative infections. 4,5 At the same time, there is increasing evidence suggesting that post-transplant, the large intestinal (gut) microbiota of recipients is altered. [6][7][8] Various factors may influence the structural and functional characteristics of the gut microbiota including age, medications, medical conditions, and diet.…”