Gut microbial balance and liver transplantation: alteration, management, and prediction

Abstract

Liver transplantation is a conventional treatment for terminal stage liver diseases. However, several complications still hinder the survival rate. Intestinal barrier destruction is widely observed among patients receiving liver transplant and suffering from ischemia–reperfusion or rejection injuries because of the relationship between the intestine and the liver, both in anatomy and function. Importantly, the resulting alteration of gut microbiota aggravates graft dysfunctions during the process. This article reviews the research progress for gut microbial alterations and liver transplantation. Especially, this work also evaluates research on the management of gut microbial alteration and the prediction of possible injuries utilizing microbial alteration during liver transplantation. In addition, we propose possible directions for research on gut microbial alteration during liver transplantation and offer a hypothesis on the utilization of microbial alteration in liver transplantation. The aim is not only to predict perioperative injuries but also to function as a method of treatment or even inhibit the rejection of liver transplantation.

Keywords

gut microbial balance / liver transplantation / ischemia–reperfusion / acute rejection

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Acknowledgements

This work was supported by the Innovative Research Groups of National Natural Science Foundation of China (No. 81421062), Major Program of the National Natural Science Foundation of China (No. 91542205), Natural Science Foundation of Zhejiang Province (No. LQ13H160004), Zhejiang Medical and Health Technology Program (No. 201472813), and Independent Research Program of Zhejiang University (No. 2016FZA7012).

Compliance with ethics guidelines

Xinyao Tian, Zhe Yang, Fangzhou Luo, and Shusen Zheng declare that they have no conflicts of interest. This manuscript is a review article and does not involve a research protocol requiring approval by the relevant institutional review board or ethics committee.

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2017 Higher Education Press and Springer-Verlag GmbH Germany