Gut Microbiota and Liver Transplantation: Immune Mechanisms Behind the Rejection

Overview

Journal Biomedicines

Specialty Biomedical Engineering

Date 2023 Jul 29

PMID 37509432

Authors

Ludovico Abenavoli

Giuseppe Guido Maria Scarlata

Maria Rosaria Paravati

Luigi Boccuto

Francesco Luzza

Emidio Scarpellini

Affiliations

Soon will be listed here.

Abstract

Liver transplantation (LT) is the treatment of choice for patients with cirrhosis, decompensated disease, acute liver failure, and hepatocellular carcinoma (HCC). In 3-25% of cases, an alarming problem is acute and chronic cellular rejection after LT, and this event can lead to the need for new transplantation or the death of the patient. On the other hand, gut microbiota is involved in several mechanisms sustaining the model of the "gut-liver axis". These include modulation of the immune response, which is altered in case of gut dysbiosis, possibly resulting in acute graft rejection. Some studies have evaluated the composition of the gut microbiota in cirrhotic patients before and after LT, but few of them have assessed its impact on liver rejection. This review underlines the changes in gut microbiota composition before and after liver transplantation, hypothesizing possible immune mechanisms linking dysbiosis to transplantation rejection. Evaluation of changes in the gut microbiota composition in these patients is therefore essential in order to monitor the success of LT and eventually adopt appropriate preventive measures.

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