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Frontiers of Medicine

ISSN 2095-0217

ISSN 2095-0225(Online)

CN 11-5983/R

Postal Subscription Code 80-967

2018 Impact Factor: 1.847

Front. Med.    2018, Vol. 12 Issue (2) : 123-129    https://doi.org/10.1007/s11684-017-0563-2
REVIEW |
Gut microbial balance and liver transplantation: alteration, management, and prediction
Xinyao Tian, Zhe Yang, Fangzhou Luo, Shusen Zheng()
Department of Hepatobiliary and Pancreatic Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China; Key Laboratory of Combined Multi-organ Transplantation, Ministry of Public Health, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
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Abstract

Liver transplantation is a conventional treatment for terminal stage liver diseases. However, several complications still hinder the survival rate. Intestinal barrier destruction is widely observed among patients receiving liver transplant and suffering from ischemia–reperfusion or rejection injuries because of the relationship between the intestine and the liver, both in anatomy and function. Importantly, the resulting alteration of gut microbiota aggravates graft dysfunctions during the process. This article reviews the research progress for gut microbial alterations and liver transplantation. Especially, this work also evaluates research on the management of gut microbial alteration and the prediction of possible injuries utilizing microbial alteration during liver transplantation. In addition, we propose possible directions for research on gut microbial alteration during liver transplantation and offer a hypothesis on the utilization of microbial alteration in liver transplantation. The aim is not only to predict perioperative injuries but also to function as a method of treatment or even inhibit the rejection of liver transplantation.

Keywords gut microbial balance      liver transplantation      ischemia–reperfusion      acute rejection     
Corresponding Authors: Shusen Zheng   
Just Accepted Date: 30 October 2017   Online First Date: 28 December 2017    Issue Date: 02 April 2018
 Cite this article:   
Xinyao Tian,Zhe Yang,Fangzhou Luo, et al. Gut microbial balance and liver transplantation: alteration, management, and prediction[J]. Front. Med., 2018, 12(2): 123-129.
 URL:  
http://academic.hep.com.cn/fmd/EN/10.1007/s11684-017-0563-2
http://academic.hep.com.cn/fmd/EN/Y2018/V12/I2/123
Fig.1  Liver IPC improved intestinal inflammation and barrier function following liver transplantation (LT) in rats. (A) Intestinal mucosal ultrastructure obtained by transmission electron microscopy (TEM) in rats following LT. MV, microvilli; TJ, tight junction. (B) Serum endotoxin was detected in the different groups. (C) sIgA content in feces was calculated by enzyme-linked immunosorbent assay (ELISA) and expressed as nanograms per gram wet feces in the different groups. (D) Serum tumor necrosis factor-α was determined by ELISA in the different groups. *P<0.05, **P<0.01, and ***P<0.001.
Fig.2  Dynamic alterations of hepatic graft function and structure during AR after OLT. (A) Representative hepatic graft histopathology stained with H&E (200×). (B) Representative hepatocyte ultrastructure observed by TEM. (C) Changes in plasma levels of ALT and AST at different time points after OLT. H&E, hematoxylin–eosin; TEM, transmission electron microscopy; AR, acute rejection; OLT, orthotopic liver transplantation; N, cell nucleus; M, mitochondria.
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