Effects of Gut Metabolites and Microbiota in Healthy and Marginal Livers Submitted to Surgery

Abstract

Microbiota is defined as the collection of microorganisms within the gastrointestinal ecosystem. These microbes are strongly implicated in the stimulation of immune responses. An unbalanced microbiota, termed dysbiosis, is related to the development of several liver diseases. The bidirectional relationship between the gut, its microbiota and the liver is referred to as the gut–liver axis. The translocation of bacterial products from the intestine to the liver induces inflammation in different cell types such as Kupffer cells, and a fibrotic response in hepatic stellate cells, resulting in deleterious effects on hepatocytes. Moreover, ischemia-reperfusion injury, a consequence of liver surgery, alters the microbiota profile, affecting inflammation, the immune response and even liver regeneration. Microbiota also seems to play an important role in post-operative outcomes (i.e., liver transplantation or liver resection). Nonetheless, studies to determine changes in the gut microbial populations produced during and after surgery, and affecting liver function and regeneration are scarce. In the present review we analyze and discuss the preclinical and clinical studies reported in the literature focused on the evaluation of alterations in microbiota and its products as well as their effects on post-operative outcomes in hepatic surgery.

Role of Dietary Nutritional Treatment on Hepatic and Intestinal Damage in Transplantation with Steatotic and Non-Steatotic Liver Grafts from Brain Dead Donors

“…It has been widely reported that polysaccharides are the most abundant dietary components [ 61 ]. In the course of intestinal fermentation, polysaccharides can promote the growth of certain intestinal bacteria, thus changing the profile of the intestinal microbiota [ 62 ], which can contribute to the development of intestinal diseases and consequently have a negative effect on organs such as the liver [ 63 ], which may result in a reduction in the quality of liver grafts [ 64 ]. Of scientific and clinical interest, it has been clearly demonstrated that microbiota imbalance can provoke immune alterations and potentiate proinflammatory pathways [ 59 , 60 ].…”

Colostrum Therapy for Human Gastrointestinal Health and Disease

“…There is also increasing awareness of the adverse consequences of mucosal barrier failure in disorders not primarily originating in the gut, notably sepsis in critical illness [10] and HIV infection [12,13]. Furthermore, several disorders of the liver are accelerated by mi-crobial translocation [14], including alcoholic [15] and non-alcoholic fatty liver disease (NAFLD) [16].…”

Role of FGF15 in Hepatic Surgery in the Presence of Tumorigenesis: Dr. Jekyll or Mr. Hyde?

“…BD negatively affects the hepatic function following transplantation [3,4], and livers with steatosis are more susceptible to ischemia-reperfusion (IR) injury, thus negatively affecting liver function and graft quality [5]. Therefore, many liver grafts are discarded, exacerbating the shortage of grafts [2,6]. In the surgery of hepatic resections, IR injury is currently performed to avoid excessive bleeding [7].…”

“…In the surgery of hepatic resections, IR injury is currently performed to avoid excessive bleeding [7]. On the other hand, IR injury negatively affects regenerative capacity after partial hepatectomy (PH) [6], particularly in steatotic livers, resulting in the worst postoperative outcomes [6,8].…”