Characteristics Of Gut Microbiota And Early Diarrhea After Renal Transplantation

Research Background and Purpose:Diarrhea after kidney transplantation is a serious complication related to graft survival and patient survival.The cause of diarrhea after transplantation is often unexplained and may be related to changes in the gut microecology of the recipients.Under the background of kidney transplant recipients taking immunosuppressive drugs for a long time,this study explored the characteristics of gut microbiota of recipients with diarrhea after kidney transplantation,providing new ideas for the study of the occurrence and development of diarrhea after transplantation,and thus providing evidence reference for the diagnosis and treatment of diarrhea after transplantation.Materials and Methods:Forty renal transplant recipients were prospectively recruited from October 2021 to May 2022 at the Organ Transplant Center of Sichuan Provincial People’s Hospital and followed up for the first three months after surgery,including 15 in the diarrhea group and 25 in the non-diarrhea group.By sequencing the V4-V5 region of 16 S r RNA gene in 115 stool samples,the composition,abundance and difference species of gut microbiota between the diarrhea group and the non-diarrhea group were analyzed;the change characteristics of the gut microbiota in the high and low tacrolimus valley concentration subgroups in the diarrhea group were analyzed;the change characteristics of the gut microbiota between the diarrhea specimens and the postdiarrhea specimens were analyzed;the change characteristics of the gut microbiota in the non-diarrhea group for three consecutive months were analyzed;prediction of gut microbiota function between the diarrhea group and the non-diarrhea group were analyzed.Results:1.There was significant difference in β diversity between diarrhea group and nondiarrhea group,but no significant difference in α diversity.2.Linear discriminant analysis effect size(LEf Se)analysis showed that the relative average abundance of Peptostreptococcacea,Lachnospiraceae,Romboutsia,Bacteroides-fragilis,Romboutsia-ilealis and Peptostreptococcales-Tissierellales were significantly decreased in diarrhea recipients.3.The relative average abundance of UBA1819,Faecalitalea,Anaerococcus,Absiella-argi,Parabacteroides-merdae and Blautia-sp-N6H1-15 in stool samples of high tacrolimus valley point concentrationgs subgroup decreased significantly.4.Compared with the diarrhea specimens,the relative average abundance of Roseburia,Subdoligranulum,Escherichia Shigella and Blautia in the post-diarrhea specimens was further reduced.5.The relative average abundance of Roseburia and Bacteroides in the nondiarrhea group continued to increase during the first three months after surgery.6.Predictive metagenomic function showed that significant reductions in metabolic pathways such as sucrose and starch metabolism,carbohydrate metabolism,degradation of other glycans,and oxidative phosphorylation in stool samples from diarrhea Conclusion:The results of this study indicate that the gut microbiota of recipients with early diarrhea after kidney transplantation is dysbiosis,and may indirectly participate in the occurrence of post-transplantation diarrhea by affecting the production of short chain fatty acids in the intestine.