Chen Zehuan, Chang Xinhua, Ye Qianyu, Gao Yifang, Deng Ronghai
Organ Transplantation Center, Sun Yat-sen University First Affiliated Hospital.
Guangdong Provincial Key Laboratory of Organ Donation and Transplant Immunology, Sun Yat-sen University First Affiliated Hospital.
Clin Kidney J. 2024 Aug 14;17(8):sfae214. doi: 10.1093/ckj/sfae214. eCollection 2024 Aug.
Kidney transplantation is an effective way to improve the condition of patients with end-stage renal disease. However, maintaining long-term graft function and improving patient survival remain a key challenge after kidney transplantation. Dysbiosis of intestinal flora has been reported to be associated with complications in renal transplant recipients. The commensal microbiota plays an important role in the immunomodulation of the transplant recipient responses. However, several processes, such as the use of perioperative antibiotics and high-dose immunosuppressants in renal transplant recipients, can lead to gut dysbiosis and disrupt the interaction between the microbiota and the host immune responses, which in turn can lead to complications such as infection and rejection in organ recipients. In this review, we summarize and discuss the changes in intestinal flora and their influencing factors in patients after renal transplantation as well as the evidence related to the impact of intestinal dysbiosis on the prognosis of renal transplantation from and clinical studies, and conclude with a discussion of the use of microbial therapy in the transplant population. Hopefully, a deeper understanding of the function and composition of the microbiota in patients after renal transplantation may assist in the development of clinical strategies to restore a normal microbiota and facilitate the clinical management of grafts in the future.
肾移植是改善终末期肾病患者病情的有效方法。然而，肾移植后维持长期移植物功能和提高患者生存率仍然是一项关键挑战。据报道，肠道菌群失调与肾移植受者的并发症有关。共生微生物群在移植受者免疫调节反应中起重要作用。然而，肾移植受者围手术期使用抗生素和大剂量免疫抑制剂等多种因素可导致肠道菌群失调，破坏微生物群与宿主免疫反应之间的相互作用，进而导致器官受者出现感染和排斥等并发症。在本综述中，我们总结并讨论了肾移植术后患者肠道菌群的变化及其影响因素，以及来自临床研究的肠道菌群失调对肾移植预后影响的相关证据，并讨论了微生物疗法在移植人群中的应用。希望对肾移植术后患者微生物群的功能和组成有更深入的了解，有助于制定恢复正常微生物群的临床策略，并在未来促进移植物的临床管理。
