Microbiome changes following biliary complications post liver transplantation
There continues to be a high demand for organs, but a limited supply resulting in up to 15 percent of patients dying while awaiting liver transplantation. To combat this, more donation after cardiac death (DCD) donors are used.
The use of DCD livers is associated with biliary complications (eg. infection, strictures or narrowing). These complications shorten the lifespan of the liver and the patient.
In clinical practice, biliary complications are diagnosed based on symptoms or lab tests (fever, abdominal pain, elevated liver enzymes). The intestinal microbiome (IM) is important for the maintenance of immune function and metabolism.
In disease states there is an imbalance in either the type of microorganisms present, or organism diversity; this is known as dysbiosis. Liver transplantation and use of anti-rejection medications have an impact on the IM and predispose the transplant recipient to biliary injury.
Our aims are:
Evaluate changes in the IM and biliary microbiome following biliary complications post-liver transplant.
Evaluate changes in IM and biliary microbiome in relation to anti-rejection medication use. The IM and biliary microbiome represent an exciting avenue in helping doctors diagnose and treat complications. For example, changes in the microbiome may help to diagnose patients and determine who may be at risk for these complications. These changes may also suggest potential targets for treatment. Preventing early biliary complications will lead to improved lifespan of the transplanted liver and the patient.