Gut Dysbiosis May Reduce Your Chance of Survival Following an Organ Transplant

Your gut microbiome is a key driver of your health in many ways. From influencing your immune system functioning, metabolism of the food you eat as well as the health of your organs. New research now adds another potential influence on your health and longevity. The gut microbiome may influence the risk of death of recipients of a liver or kidney organ transplant.

Research suggests that those who have chronic liver and kidney disease have dysbiosis in their gut microbiome. This imbalance in health promoting and disease promoting microbes continues as the disease worsens and the liver and kidney function continues to decline, ultimately until an organ transplant is required. New research suggests that the organ transplant itself is linked to a change in the gut microbiome to cause dysbiosis. This exposes another level of complexity and role that the gut microbiome could potentially play.

Researchers studied four hundred and fifteen people who were recipients of a liver transplant and six hundred and seventy-two recipients of a kidney transplant. The researchers studied one thousand three hundred and seventy stool samples of these transplant recipients. To compare the differences in microbes one thousand one hundred and eighty-three control stool samples were also analysed. The researchers followed seventy-eight of the six hundred and seventy-two recipients of the kidney transplant for two years after their surgery.

Researchers found that the recipients of an organ transplant had a change in their gut microbiome. Their gut microbiome became less diverse and less health promoting microbes resided in their gut. For example, species such as Coprobacter fastidiosus and Clostridium asparagiforme became more abundant whereas Ruminococcus obeum and Akkermansia muciniphila species declined.

In addition to this, some of the recipients of an organ transplant had genes present which are linked to antibiotic resistance. There are many reasons that an optimal gut microbiome is essential for health. Researchers found that this gut dysbiosis was linked to increased risk of death following the organ transplant. Ninety six percent of those with a high diversity of gut microbes survived three years following an organ transplant compared to seventy seven percent in those individuals with a low diversity of gut microbes three years after an organ transplant.

It is an unfortunate finding that the drugs which are regularly used to weaken the immune system to support organ acceptance were a main contributing factor to the changes in the gut microbiome.

These changes were not acute in some people who received an organ transplant. Researchers noted a continuation of this alteration in the gut microbiome up to twenty years following the organ transplant.

The take home message from this new research is a healthy gut microbiome appears to be a key component of successful organ transplantation. More research is needed to increase insight of the potential link between your gut microbiome and transplant, but these findings may alter the future the recommendations for individuals needing an organ transplant. This could mean prescribing a diet and lifestyle habits which support an optimal gut microbiome.  This may increase the chance of survival following an organ transplant.

A diet which is high in plant-based foods give prebiotic fibre and other components like polyphenols which feed the health promoting microbes in your gut. Plant based foods like wholegrains, nuts, seeds, legumes, beans, fruits, and vegetables. A healthy lifestyle goal can be aiming to include thirty different plant-based foods a week. Each different prebiotic fibre feeds a different type of health promoting microbe and can help to increase the diversity in your gut microbiome.

In an addition to eating a diet which is made up mostly of plant-based foods including two serves of probiotic rich and fermented foods a day is important. This includes foods like probiotic rich yoghurt, miso, tempeh, sauerkraut, or natto.

Take home message: If you are yet to jump on the band wagon on lifestyle habits which support your gut health now is the time. The ability of your gut microbiome to impact most of the systems in your body is becoming increasingly apparent. This new research provides potential insight of a powerful new way your gut microbiome may impact the outcomes of those needing an organ transplant.  

References:

  1. Swarte JC, Li Y, Hu S, Björk JR, Gacesa R, Vich Vila A, Douwes RM, Collij V, Kurilshikov A, Post A, Klaassen MAY, Eisenga MF, Gomes-Neto AW, Kremer D, Jansen BH, Knobbe TJ, Berger SP, Sanders JF, Heiner-Fokkema MR, Porte RJ, Cuperus FJC, de Meijer VE, Wijmenga C, Festen EAM, Zhernakova A, Fu J, Harmsen HJM, Blokzijl H, Bakker SJL, Weersma RK. Gut microbiome dysbiosis is associated with increased mortality after solid organ transplantation. Sci Transl Med. 2022 Aug 31;14(660):eabn7566. doi: 10.1126/scitranslmed.abn7566. Epub 2022 Aug 31. PMID: 36044594.
  2. Microbiome Post, Exploring Research, Inspiring Clinical Practice. Altered gut microbiota linked with poorer survival after organ transplant. October 10 2022. https://microbiomepost.com/altered-gut-microbiota-linked-with-poorer-survival-after-organ-transplant/
  3. Acharya C, Bajaj JS. Chronic Liver Diseases and the Microbiome-Translating Our Knowledge of Gut Microbiota to Management of Chronic Liver Disease. Gastroenterology. 2021 Jan;160(2):556-572. doi: 10.1053/j.gastro.2020.10.056. Epub 2020 Nov 28. PMID: 33253686; PMCID: PMC9026577.
  4. Swarte, J. C., Douwes, R. M., Hu, S., Vich Vila, A., Eisenga, M. F., van Londen, M., ... & Bakker, S. J. (2020). Characteristics and dysbiosis of the gut microbiome in renal transplant recipients. Journal of clinical medicine, 9(2), 386.
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