Liver transplantation (LT) is crucial for end-stage liver disease, but it is linked to infection risks. Pathobionts, microorganisms potentially harmful under specific conditions, can cause complications posttransplant. Monitoring such pathogens in fecal samples can be challenging and therefore remains underexplored post-LT. This study aimed to analyze the gut microbiome before and after LT, tracking pathobionts and correlating clinical data. The study involved 17 liver transplant recipients, 17 healthy relatives (spouses), and 13 donors. Gut samples collected pretranplantation and posttransplantation underwent bacterial and fungal profiling through DNA sequencing. Quantitative polymerase chain reaction was used to assess microbial load. Statistical analyses included alpha and beta diversity measures, differential abundance analysis, and correlation tests between microbiome and clinical parameters. Microbiome analysis revealed dynamic changes in diversity posttransplant. Notably, high-severity patients showed persistent and greater dysbiosis during the first months post-LT compared with low-severity patients, partly due to an antibiotic treatment pre-LT. The analysis identified a higher proportion of pathogens such as / in high-severity cases posttransplant. Furthermore, butyrate producers including , , and were positively correlated with levels of albumin. This study offers valuable insights into post-LT microbiome changes, shedding light on the need for tailored prophylactic treatment post-LT.

中文翻译：

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肝移植后微生物组组成的恢复与初始肝病严重程度和抗生素治疗相关

肝移植（LT）对于终末期肝病至关重要，但它与感染风险有关。病原体，即在特定条件下可能有害的微生物，可能会导致移植后并发症。监测粪便样本中的此类病原体可能具有挑战性，因此在 LT 后仍未得到充分研究。本研究旨在分析 LT 前后的肠道微生物组，追踪致病菌并关联临床数据。该研究涉及 17 名肝移植受者、17 名健康亲属（配偶）和 13 名捐献者。移植前和移植后收集的肠道样本通过 DNA 测序进行细菌和真菌分析。使用定量聚合酶链反应来评估微生物负荷。统计分析包括α和β多样性测量、差异丰度分析以及微生物组和临床参数之间的相关性测试。微生物组分析揭示了移植后多样性的动态变化。值得注意的是，与低严重程度患者相比，高严重程度患者在 LT 后的头几个月表现出持续且更严重的生态失调，部分原因是 LT 前的抗生素治疗。分析发现，在移植后严重程度较高的病例中，病原体的比例较高。此外，包括 、 、 和 在内的丁酸盐生产者与白蛋白水平呈正相关。这项研究提供了关于 LT 后微生物组变化的宝贵见解，揭示了 LT 后定制预防性治疗的必要性。