Kidney Week

Abstract: TH-PO835

Intestinal Microbiome and Acute Rejection of the Transplanted Kidney: Results of Single-Center, Case-Control Study

Session Information

• Transplantation: Clinical - 2
  October 24, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Transplantation

• 2102 Transplantation: Clinical

Authors

• Adamczak, Marcin, Department of Nephrology, Transplantation and Internal Medicine, Medical University of Silesia, Katowice, Poland

Marcin Adamczak, MD, PhD

• Pokora, Patrycja, Department of Nephrology, Transplantation and Internal Medicine, Medical University of Silesia, Katowice, Poland

Patrycja Pokora, MD

• Kaczmarczyk, Mariusz, Sanprobi sp. z o.o, Szczecin, Poland

Mariusz Kaczmarczyk, MD, PhD

• Gojowy, Damian, Department of Nephrology, Transplantation and Internal Medicine, Medical University of Silesia, Katowice, Poland

Damian Gojowy

• Wierzbicka-Wos, Anna, Sanprobi sp. z o.o, Szczecin, Poland

Anna Wierzbicka-Wos

• Cembrowska-Lech, Danuta, Sanprobi sp. z o.o, Szczecin, Poland

Danuta Cembrowska-Lech, PhD

• Kolonko, Aureliusz, Department of Nephrology, Transplantation and Internal Medicine, Medical University of Silesia, Katowice, Poland

Aureliusz Kolonko, MD, PhD

• Loniewski, Igor Igor, Department of Biochemical Science, Faculty of Health Sciences, Pomeranian Medical University, Szczecin, Poland

Igor Igor Loniewski, MD, PhD

• Wiecek, Andrzej, Department of Nephrology, Transplantation and Internal Medicine, Medical University of Silesia, Katowice, Poland

Andrzej Wiecek, MD, PhD, FASN

Background

Kidney transplantation (KTx) is the preferred form of renal replacement therapy. Acute rejection of transplanted kidney (AR) shortly after KTx may impair long-term survival of the kidney graft and the recipients. The relationship between gut microbiota and kidney rejection remains underexplored. This study aimed to investigate the relationship between gut microbiome and the risk of AR shortly after KTx.

Methods

In this single-center, retrospective case-control study, 10 patients with biopsy proved AR shortly after KTx (mean age 44.7 ± 12.3 years; 8M/2F) were matched by sex and age with 20 patients without AR during one year follow up after KTx (mean age 43.7 ± 10.7 years; 16M/4F). Stool samples were collected 4-7 days after KTx for microbiome analysis using Illumina shallow shotgun sequencing. Bioinformatic analysis included taxonomic and functional profiling, with predictive modeling performed using a random forest model. Model performance was evaluated using receiver operating characteristic (ROC) curves and area under the curve (AUC).

Results

No significant differences in clinical characteristics or microbiota diversity were observed between two groups. Differential abundance analysis identified Bacteroides dorei/vulgatus and Clostridium as differentially abundant in AR patients, but no consistent taxonomic markers were found. Predictive models varied in performance, with functional KEGG pathway profiles showing the highest predictive value (AUC = 0.740). Key metabolic pathways implicated included lipid metabolism (e.g., sphingolipid metabolism, glycerophospholipid metabolism, and secondary bile acid biosynthesis), glycan biosynthesis, and terpenoid and polyketide metabolism.

Conclusion

1. No universal taxonomic gut microbiota marker of AR was identified. 2. Functional profile of the gut microbiome may be related with AR, with specific metabolic pathways 3. These findings suggest a role for immunomodulation, inflammation, and metabolic regulation in AR, highlighting the need for further research to understand these associations and their impact on kidney transplant outcomes.

Funding

• Government Support – Non-U.S.