【Cover】Damage to intestinal bacteria is related to the reduced survival rate of organ transplant recipients| Science and Translational Medicine

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Based on a new study of samples containing more than a thousand liver or kidney transplant recipients, scientists have linked
the destruction of gut bacteria to reduced survival after organ transplantation.

Their study, which also included a two-year follow-up of some kidney transplant recipients, confirmed that the gut microbiota has an important effect on transplant outcomes, suggesting that microbiota-based treatments may help improve outcomes in
transplant patients.

The study appeared on the cover
of this issue of Science Translational Medicine.

Organ transplantation is a life-saving but extremely delicate procedure; There is a high risk
of organ rejection, infection and death after transplantation.

Some reports suggest harmful changes in the gut microbiota of patients undergoing stem cell transplants, but it is unclear whether this will also occur after
parenchymal organ transplantation.
Johann Swarte and colleagues sequenced 1,370 stool samples from 415 liver transplant recipients and 672 kidney transplant recipients to try to clarify how the gut microbiome would change
after transplantation.

The research team also looked at samples from 1,183 controls and followed 78 kidney transplant recipients for two years after transplantation
.
Overall, these patients who received organ transplants showed typical signs of microbiota disruption that lasted up to 20 years, including decreased diversity of gut bacteria and an increased
incidence of genes associated with antibiotic resistance.

Patients with the lowest diversity of intestinal bacteria also had lower survival rates of 77 percent, compared with 96 percent
for patients with high diversity of intestinal bacteria.
The analysis also showed that the use of immunosuppressive drugs needed to prevent organ rejection was the most important factor driving the disruption of
the microbiome.

Swarte et al.
caution that their study does not prove causation and say their research should be extended to patients receiving heart-lung transplants
in the future.
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