Microbes and Allogeneic Transplantation

Alegre, Maria‐Luisa; Bartman, Caroline; Chong, Anita S.

doi:10.1097/tp.0b013e3182a2037f

Cited by 19 publications

(17 citation statements)

References 66 publications

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“…Alterations in the microbiota may also have an impact on alloimmunity, as recently reviewed (18). As the study of the interplay between the microbiome and immune system, and in particular alloimmunity, is still in its infancy, it is unclear how the altered microbiota SOT recipients, and of FMT recipients, affect the graft.…”

Section: Discussionmentioning

confidence: 99%

Fecal Microbiota Transplantation for Refractory Clostridium difficile Colitis in Solid Organ Transplant Recipients

Friedman‐Moraco

Mehta

Lyon

et al. 2014

American Journal of Transplantation

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Fecal microbiota transplantation (FMT) has been shown to be safe and efficacious in individuals with refractory Clostridium difficile . It has not been widely studied in individuals with immunosuppression due to concerns about infectious complications. We describe two solid organ transplant recipients, one lung and one renal, in this case report that both had resolution of their diarrhea caused by C. difficile after FMT. Both recipients required two FMTs to achieve resolution of their symptoms and neither had infectious complications. Immunosuppressed individuals are at high risk for acquisition of C. difficile and close monitoring for infectious complications after FMT is necessary, but should not preclude its use in patients with refractory disease due to C. difficile . Sequential FMT may be used to achieve cure in these patients with damaged microbiota from antibiotic use and immunosuppression.

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Section: Discussionmentioning

confidence: 99%

Fecal Microbiota Transplantation for Refractory Clostridium difficile Colitis in Solid Organ Transplant Recipients

Friedman‐Moraco

Mehta

Lyon

et al. 2014

American Journal of Transplantation

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“…Evidence is beginning to mount that the immunological challenge of organ transplantation may be one of the processes influenced by commensal microbes (4). However, understanding of the interaction between transplant immunity and commensals is in its infancy.…”

Section: Introductionmentioning

confidence: 99%

The influence of the microbiota on the immune response to transplantation

Bartman

Chong²,

Alegre

2015

Current Opinion in Organ Transplantation

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Purpose of review In the past decade, appreciation of the important effects of commensal microbes on immunity has grown exponentially. The effect of the microbiota on transplantation has only recently begun to be explored; however, our understanding of the mechanistic details of host-microbe interactions is still lacking. Recent findings It has become clear that transplantation is associated with changes in the microbiota in many different settings although what clinical events and therapeutic interventions contribute to these changes remains to be parsed out. Research groups have begun to identify associations between specific communities of organisms and transplant outcomes but it remains to be established whether microbial changes precede or follow transplant rejection episodes. Finally, results from continuing exploration of basic mechanisms by which microbial communities affect innate and adaptive immunity in various animal models of disease continues to inform research on the microbiota’s effects on immune responses against transplanted organs. Summary Commensal microbes may alter immune responses to organ transplantation, but direct experiments are only beginning in the field to identify species and immune pathways responsible for these putative effects.

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“…These considerations have been largely discussed in the context of organ transplantation by Alegre et al 80 and Chong and Alegre, 81 where infections and/or tissue damage directly or indirectly affect alloreactivity and the outcome of transplanted allografts. Hence, three scenarii can be envisioned to explain how T-cell responses elicited by commensals could influence antitumor immunity.…”

Section: Ly6cmentioning

confidence: 99%