Update on the reciprocal interference between immunosuppressive therapy and gut microbiota after kidney transplantation

Core Tip

Core Tip: Gut dysbiosis frequently occurs in the first period after kidney transplantation. Among the different causes, immunosuppressive drugs play a relevant role. There is a reciprocal effect between immunosuppressive drugs and the gut microbiota. Indeed, immunosuppressive drugs may change the gut microbiota composition causing dysbiosis as related side effects as rejection and infections. In contrast, the gut microbiota may alter the pharmacokinetic of immunosuppressive drugs determining modification in their metabolism and favoring the presence of substances with lower or higher immunosuppressant effect with respect to the original compound. Physicians should pay particular attention to these possibilities and carefully control both changes in the gut microbiota and the correct level of immunosuppressive drugs.