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World J Transplant. Jul 18, 2022; 12(7): 157-162
Published online Jul 18, 2022. doi: 10.5500/wjt.v12.i7.157
Gut microbiome dysbiosis in the setting of solid organ transplantation: What we have gleaned from human and animal studies
Aparna Sharma, Emmanouil Giorgakis
Aparna Sharma, Department of Nephrology, University of Arkansas for Medical Sciences, Little Rock, AR 72223, United States
Emmanouil Giorgakis, Department of Surgery, University of Arkansas for Medical Sciences, Little Rock, AR 72223, United States
Author contributions: Sharma A and Giorgakis E contributed to the manuscript drafting and revision.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Aparna Sharma, MD, Assistant Professor, Department of Nephrology, University of Arkansas for Medical Sciences, 4301 West Markham Street, Little Rock, AR 72223, United States. asharma@uams.edu
Received: March 31, 2021
Peer-review started: March 31, 2021
First decision: September 29, 2021
Revised: October 27, 2021
Accepted: June 21, 2022
Article in press: June 21, 2022
Published online: July 18, 2022
Processing time: 471 Days and 2.8 Hours
Abstract

The human gut microbiome refers to all of the microorganisms present throughout the length of the gastrointestinal tract. Gut flora influence host metabolic and immune processes in myriad ways. They also play an important role in maturation and modulation of the immune system. Dysbiosis or a pathologic alteration in gut flora has been implicated in a number of diseases ranging from metabolic, autoimmune and degenerative. Whether dysbiosis has similar implications in organ transplant has been the focus of a number of pre-clinical and clinical studies. Researchers have observed significant microbiome changes after solid organ transplantation in humans that have been associated with clinical outcomes such as post-transplant urinary tract infections and diarrhea. In this article, we will discuss the available data regarding pathologic alterations in gut microbiome (dysbiosis) in solid organ transplant recipients as well as some of challenges in this field. We will also discuss animal studies focusing on mouse models of transplantation that shed light on the underlying mechanisms that explain these findings.

Keywords: Dysbiosis; Gut microbiome; Innate immunity; Short chain fatty acids; Toll like receptors; Tolerance

Core Tip: The human gut microbiome refers to all of the microorganisms present throughout the length of the gastrointestinal tract. Gut flora influence host metabolic and immune processes in myriad ways. Gut microbiota alterations have been described in solid organ recipients. In this review we discuss available human studies about changes in gut flora in solid organ transplant such as kidney, liver and small bowel.