Date: Saturday, May 30, 2020
Session Time: 3:15pm-4:00pm
Presentation Time: 3:30pm-4:00pm
*Purpose: Non-alcoholic fatty liver disease (NAFLD) and its progressive form non-alcoholic steatohepatitis (NASH) is a growing problem globally and recurs even after liver transplant (LT). We aim to characterize the gut dysbiosis in patients who developed recurrent NAFLD compared to patients without recurrence following LT.
*Methods: A prospective analysis was performed on 21 patients who received LT for the primary indication of NASH at a single center and had a protocol liver biopsy performed beyond 1 year post-LT. Genomic DNA extraction, next-generation sequencing, and quantitative PCR analysis were performed on stool samples collected at time of the biopsy.
*Results: Recurrent NAFLD was noted in 15 of the 21 included patients, and they had significantly higher AST (P=.01), ALT (P=.04), and triglycerides level (P=.02). Stool microbiome analysis at the genus level showed significant loss of Akkermansia and increasing Fusobacterium associated with NAFLD recurrence . qPCR analysis revealed significantly decreased relative abundance of Firmicutes in patients with NAFLD activity scores (NAS) ≥ 5 as compared to patients with lower NAS scores, while Bacteroidetes were significantly increased with higher NAS (P<.05). Firmicutes (P=.007) and Bifidobacterium group (P=.037) were reversely correlated while Bacteroidetes (P=.001) showed a positive correlation with higher hepatic steatosis content. The Firmicutes/Bacteroidetes ratios were higher in patients without NAFLD or NASH as compared to patients diagnosed with NAFLD or NASH at the time of sample collection.
*Conclusions: Akkermansia, Firmicutes, and Bifidobacterium may play protective roles in the development of recurrent NAFLD in LT recipients, while Fusobacteria and Bacteroidetes may play pathogenic roles. These findings highlight the potential role of the “gut-liver” axis in the pathogenesis of NAFLD recurrence after LT.
To cite this abstract in AMA style:Sataphaty S, Banerjee P, Pierre J, Heda R, Dutta S, Higgins DD, Mas V, Khan S, Mupparaju V, Nair SR, Eason JD, Kleiner D, Maluf D. Characterization of Gut Microbiome in Liver Transplant Recipients with Non-Alcoholic Steatohepatitis [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/characterization-of-gut-microbiome-in-liver-transplant-recipients-with-non-alcoholic-steatohepatitis/. Accessed February 24, 2021.
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