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Abstract: SA-OR091

Change of Gut Microbiome after Kidney Transplantation and Its Impact on Acute Rejection

Session Information

Category: Transplantation

  • 1801 Transplantation: Basic


  • Kim, Ji Eun, Seoul National University Hospital, Seoul, Korea (the Republic of)
  • Cho, Hyunjeong, Chungbuk National University Hospital, Cheongju-si, Chungcheongbuk-do, Korea (the Republic of)
  • Park, Ji In, Kangwon National University Hospital, Chuncheon-si,, Korea (the Republic of)
  • Kim, Dong Ki, Seoul National University Hospital, Seoul, Korea (the Republic of)
  • Yang, Seung Hee, Kidney Research Institute, Seoul National University, Seoul, Korea (the Republic of)
  • Lee, Jung Pyo, Seoul National University Boramae Medical Center, Seoul, Korea (the Republic of)
  • Kim, Yon Su, Seoul National University College of Medicine, Seoul, Korea (the Republic of)
  • Lee, Hajeong, Seoul National University College of Medicine, Seoul, Korea (the Republic of)

Gut microbiota regulates immune responses and its dysbiosis is associated with various kinds of diseases, although very few studies have been conducted in kidney transplantation recipients. The purpose of this study is to analyze the changes of gut microbiome after renal transplantation and to evaluate the association between bacterial composition and post-transplantation outcomes.


We prospectively enrolled renal transplant recipients at 2 tertiary centers. We gathered their fresh feces before and three-month after receiving transplantation. The Illumina MiSeq system was used for sequencing of the 16S rRNA V4-V5 variable region from the extracted stool DNA. We explored gut microbiome profile change before and after transplantation and its impact on transplantation outcomes such as acute rejection (AR) and infection occurrences.


From 76 recipients, we analyzed 76 feces before transplantation and 39 feces after transplantation. Microbial diversity decreased significantly in three months after transplantation than pre-transplantation period (p<0.001). At the phylum level, Proteobacteria significantly increased in post-transplantation state (p=0.046). At the genus level, relative proportions of Oscillibacter (p=0.001), Subdoligranulum (p=0.018), and Alistipes (p=0.005) significantly decreased, whereas the genera Clostridium_g24 significantly increased (p=0.016) in post-transplantation period. When we compared gut microbiome profiles between patients with and without transplantation outcomes, both observed operational taxonomic unit (p=0.029) and microbial diversity (p=0.014) were significantly lower in AR group. AR group tended to have lower phylum Bacteroidetes, higher phylum Proteobacteria, and lower abundance of the genera Faecalibacterium than non-AR group, although insignificant. Recipients with infection episodes had lesser the genera Oscillibacter (p=0.019) than those without. In addition, they had higher abundance of the genera Bacteroides (p=0.037) than those without.


In this study, we demonstrate significant sequential changes as well as a decreased diversity of gut microbiota after kidney transplantation. Interestingly, transplantation outcomes including AR and infection episodes were associated with changes of gut microbiota in recipients.