Gut Microbiome in Kidney Transplant Recipients

J.C. Swarte, H.J.M. Harmsen, S.J.L. Bakker

Thursday 15 march 2018

17:05 - 17:15h at Willem Burger Zaal

Categories: Clinical, Session (parallel)

Parallel session: Parallel session 8: Clinical

Background & Aim

All transplantation patients are in need of immunosuppressive drugs to prevent allograft rejection. Chronic immunosuppression leads to an increased occurrence of bacterial infections, in turn leading to an increased use of antibiotics. Both immunosuppression and antibiotic use may change the intestinal flora. Transplantation patients are therefore likely to suffer from intestinal dysbiosis. As an effect of intestinal dysbiosis, post-transplantation patients might suffer from an increased risk of malnutrition and diarrhoea. Consequently, the microbiome of kidney transplant recipients (KTR) has to be explored.

Methods

We analysed the microbiome by polymerase chain reaction amplification of the 16S rRNA V4-V5 region of microbiota and sequencing using the Illumina MiSeq platform. We compared the microbiome of KTR on taxonomic genus and species level to that of healthy controls, using the Mann Whitney U-test.

Results

Faecal samples of 110 KTR (38.3% female) and 79 healthy donors (34.0% female, P=0.42) were collected. The mean age was 54.6 ± 12.0 years for KTR and 59.6 ± 11.0 years for donors. The median time after transplantation was 1.08 years, with a range of 1 to 26.4 year (P<0.00). The level of Bifidobacterium (2.2 ± 4.3% for KTR and 4.5 ± 5.5% for donors), Coprococcus (3.3 ± 2.4%, 4.7 ± 2.2%), Dorea (1.6 ± 1.6%, 2.2 ± 1%), Ruminococcus (3.2 ± 3.3%, 2.7 ± 1.5%) and Oscillospira (1.0 ± 1.5%, 1.9 ± 2.4%) were significantly lower (P<0.05) in KTR. Significantly higher (P<0.05) levels of Streptococcus (8.5 ± 12.0%, 1.6 ± 3.7%) and Lactobacillus (2.8 ± 11.0%, 0.0 ± 0.2) were found in KTR compared to donors. In total 19 KTR suffered from diarrhoea and 0 donors suffered from diarrhoea (P<0.00). KTR with diarrhoea had significantly lower (P<0.05) levels of Bifidobacterium (1.4 ± 2.2%, 4.5 ± 5.4%) but higher levels (P<0.05) of Streptococcus (6.31 ± 6.6%, 1.0 ± 3.0%) and Lactobacillus (3.0 ± 7.8%, 0.0 ± 0.2). Escherichia coli (1.9 ± 4.2%, 0.3 ± 0.8) was significantly higher (P<0.05) in recipients with diarrhoea.

Conclusion

We found significant differences in the microbiome of KTR compared to healthy donors. Diarrhoea could be the effect of changes in the microbiome due to a loss of commensal microbiota. Further research is needed to explore the changes and effects of the microbiome in KTR.