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Assessment of Microbiome Variation During the Perioperative Period in Liver Transplant Patients: a Retrospective Analysis

  • Host Microbe Interactions
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Abstract

Understanding the composition of the microbial populations in the intestines of liver transplant patients is important to preventing postoperative infection. We investigated the relationship between the risk of postoperative infection and variation in the predominant fecal microbial composition during the perioperative period. We prospectively analyzed the predominant intestinal microbiome of five asymptomatic adult carriers of hepatitis B virus (as controls without any antibiotics) at four weekly follow-up visits and 12 patients before operation and at three weekly postoperative follow-up visits within the first month. Analysis was by denaturing gradient gel electrophoresis (DGGE) and sequencing with digital processing of DGGE profiles using BioNumerics software. Our results showed that the predominant intestinal microbial diversity decreased substantially in eight patients during the perioperative period. Among these, five patients experienced infection with a postoperative hospital stay of more than 30 days. The rest of the four patients who experienced shorter postoperative hospital stays showed only slight variation in predominant intestinal bacterial composition and temporal stability similar to asymptomatic controls. Postoperative fecal DGGE profiles showed mostly bands assigned to Bacteroides and Firmicutes. We conclude that an empiric prophylaxis strategy that destructs gut microecological balance will not be effective in reducing the risk of postoperative infection. Instead, the destruction of intestinal microbiota might result in the appearance of opportunistic pathogens such as Bifidobacterium dentium which rarely appears in the intestinal DGGE profiles of normal humans. Cognizance of the variation of intestinal microbial profiles during the perioperative period is a critical aspect of caring for liver transplant recipients.

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Acknowledgments

We gratefully acknowledge the physicians at the Department of Infectious Diseases and the surgeons at the Department of Surgery in the First Affiliated Hospital, College of Medicine, Zhejiang University, for their collaboration and collection of stool specimens. This study was supported by the National Basic Research Program (973) of China (2009CB522400, 2013CB531401), the Zhejiang Chinese Medicine Administrative bureau project (no. 2009ZA012), and the Zhejiang Provincial Medical Scientific Research Foundation of China (2012RCB020).

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Authors and Affiliations

  1. State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Department of Infectious Diseases, the First Affiliated College of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, 310003, China

    Haifeng Lu, Jianqing He, Zhongwen Wu, Wei Xu, Hua Zhang, Ping Ye, Jiezuan Yang & Lanjuan Li

  2. Key Lab of Organ Transplantation, Ministry of Public Health, Key Lab of Organ Transplantation and Department of Hepatobiliary and Pancreatic Surgery, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310003, People’s Republic of China

    Shusen Zhen

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  1. Haifeng Lu
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  9. Lanjuan Li
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Correspondence to Lanjuan Li.

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Lu, H., He, J., Wu, Z. et al. Assessment of Microbiome Variation During the Perioperative Period in Liver Transplant Patients: a Retrospective Analysis. Microb Ecol 65, 781–791 (2013). https://doi.org/10.1007/s00248-013-0211-6

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  • DOI: https://doi.org/10.1007/s00248-013-0211-6

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