Update on the reciprocal interference between immunosuppressive therapy and gut microbiota after kidney transplantation

Table 1 Role of gut microbiota in kidney transplantation[6-16]

Post-transplant Setting	Study population	Gut bacteria involved	Outcome
TAC dosing	KTRs (n = 19)	↑Faecalibacterium prausnizii	Increased abundance positively correlated with increased TAC dose requirements
Rejection	KTRs (n = 55)	↑Lactobacillales; ↓Clostridiales; ↑Enterococcus; ↓Barnesiellaceae; ↑Anaerofilum; ↓Paraprevotellaceae; ↑Clostridium; ↓Pasteurellaceae; Tertium; ↓Roseburia; ↓Haemophilus; ↓Faecalibacterium	Gut microbiotra alterations associated with ABMR
TAC metabolism	In vitro	Faecalibacterium prausnizii; Erysipelotricheles; Bacteroidales	Taxa able to metabolize TAC into a less effective immunosuppressant metabolite
TAC metabolism	KTRs (n = 10)	Gut bacteria	Active metabolism of TAC by the gut bacteria. The gut microbiota could impact TAC trough variability
Infection	KTRs (n = 60)	↓Clostridiales; ↓Mogibacterium; ↓Peptoniphilus; ↓Coriobacterineae	Changes in the relative abundance associated with the development of infections after six months post transplantation
Infection	KTRs (n = 168)	↑Escherichia; ↑Enterococcus	Increased abundance associated with the development of Escherichia and Enterococcus bacteriuria
Infection	KTRs (n = 168)	↑Faecalibacterium; ↑Romboutsia	Increased abundance associated with lower risk of Enterobacteriaceae bacteriuria and UTI
Infection	KTRs (n = 168)	Butyrate-producing bacteria	A relative abundance than 1% associated with lower risk of respiratory viral infection and CMV viremia
Diarrhea	KTRs (n = 64)	↑Enterococcus; ↓Eubacterium; ↑Escherichia; ↓Anaerostipes; ↑Lachnoclostridium; ↓Coprococcus; ↓Romboutsia; ↓Ruminococcus; ↓Dorea; ↓Faecalibacterium; ↓Fusicatenibacter; ↓Oscillibacter; ↓Blautia; ↓Bifidobacterium; ↓Bacteroides	Changes in the relative abundance associated with the development of diarrhea
Diarrhea	KTRs (n = 79)	↓Eubacterium; ↓Anaerostipes; ↓Ruminococcus; ↓Dorea; ↓Fusicatenibacter; ↓Bifidobacterium	Decreased relative abundance associated with the development of non.infectious diarrhea
NODAT	KTRs (n = 50)	↑Lactobacillus; ↓Akkermansia muciniphila	Changes in the relative abundance associated with the development of NODAT

TAC: Tacrolimus; KTR: Kidney transplant recipient; ABMR: Antibody mediated rejection; UTI: Urinary tract infection; CMV: Cytomegalovirus; NODAT: New onset diabetes after transplantation.