Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University and Richmond VA Medical Center, Richmond, Virginia, USA.
Curr Opin Organ Transplant. 2021 Dec 1;26(6):587-594. doi: 10.1097/MOT.0000000000000930.
Although gut dysbiosis can hasten disease progression in end-stage liver disease and contribute to disease severity, morbidity and mortality, its impact during and after transplant needs further study.
Changes in the microbiome are associated with hepatic decompensation. Immune homeostasis is further disrupted during transplant and with immunosuppressants required after transplant. There is increasing evidence of the role of microbiota in peri and posttransplant complications.
Although transplant is highly successful with acceptable survival rates, infections, rejection, disease recurrence and death remain important complications. Prognostication and interventions involving the gut microbiome could be beneficial.
尽管肠道菌群失调会加速终末期肝病的疾病进展并导致疾病严重程度、发病率和死亡率增加，但它在移植期间和之后的影响仍需要进一步研究。
微生物组的变化与肝性失代偿有关。移植过程中免疫稳态进一步受到破坏，并且在移植后需要使用免疫抑制剂。越来越多的证据表明微生物群在移植前后的并发症中起作用。
尽管移植的成功率很高，存活率也可以接受，但感染、排斥反应、疾病复发和死亡仍然是重要的并发症。涉及肠道微生物组的预后和干预可能是有益的。
