Kato Karin, Nagao Miki, Miyamoto Kentaro, Oka Kentaro, Takahashi Motomichi, Yamamoto Masaki, Matsumura Yasufumi, Kaido Toshimi, Uemoto Shinji, Ichiyama Satoshi
Department of Clinical Laboratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Tokyo R&D Center, Miyarisan Pharmaceutical. Co., Ltd., Wako, Saitama, Japan.
Transplant Direct. 2017 Mar 10;3(4):e144. doi: 10.1097/TXD.0000000000000661. eCollection 2017 Apr.
Increasing evidence suggests that the intestinal microbiota plays an important role in liver diseases. However, the dynamics of the intestinal microbiota during liver transplantation (LT) and its potential role in clinical course remain unknown.
We prospectively analyzed the intestinal microbiota of 38 patients who underwent LT in Kyoto University Hospital. We characterized the microbial compositions of fecal specimens from LT patients using a metagenomics approach by an Illumina MiSeq platform. We analyzed the diversity of microbiota sequentially from pretransplantation until 2 months after LT and also compared the microbiota during an episode of acute cellular rejection (ACR) and bloodstream infections (BSI) to the microbial composition of time-matched fecal specimens obtained from patients who did not experience ACR or BSI, respectively.
Three hundred twenty fecal specimens were analyzed. Dynamic changes were observed in the microbial composition of LT recipients during the perioperative period. Over the course of LT, the mean diversity index decreased during the first 3 weeks after LT and gradually increased during our observation period. The loss of intestinal microbiota diversity was associated with high Child-Pugh scores, high model for end-stage liver disease scores, ACR, and BSI. At the family level, , , and were increased whereas , , , and were decreased in ACR patients.
The microbiota of LT patients was associated with the severity of liver diseases and the presence of ACR and BSI. These results lay the groundwork for more comprehensive investigations of microbiota characteristics to identify diagnostic markers for transplant health and to guide intervention strategies to improve transplant outcomes.
越来越多的证据表明肠道微生物群在肝脏疾病中起重要作用。然而，肝移植（LT）期间肠道微生物群的动态变化及其在临床病程中的潜在作用仍不清楚。
我们前瞻性分析了京都大学医院38例接受LT患者的肠道微生物群。我们使用Illumina MiSeq平台通过宏基因组学方法对LT患者粪便标本的微生物组成进行了表征。我们从移植前到LT后2个月对微生物群的多样性进行了连续分析，并将急性细胞排斥反应（ACR）和血流感染（BSI）发作期间的微生物群与分别从未经历ACR或BSI的患者获得的时间匹配粪便标本的微生物组成进行了比较。
共分析了320份粪便标本。在围手术期观察到LT受者的微生物组成发生了动态变化。在LT过程中，平均多样性指数在LT后的前3周下降，并在我们的观察期内逐渐增加。肠道微生物群多样性的丧失与高Child-Pugh评分、高终末期肝病模型评分、ACR和BSI相关。在科水平上，ACR患者中、、和增加，而、、、和减少。
LT患者的微生物群与肝脏疾病的严重程度以及ACR和BSI的存在有关。这些结果为更全面地研究微生物群特征奠定了基础，以确定移植健康的诊断标志物并指导改善移植结果的干预策略。
