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Updated: Aug 5, 2026
08:25
A Rat Graft Rejection Model of Intestinal Transplantation with Exteriorized Ileostomy for Longitudinal Prognosis Assessment
Published on: June 10, 2025
Gut microbiota and acute rejection in solid organ transplantation
Montserrat Kwan1, Maria-Luisa Alegre
1Department of Medicine, University of Chicago, Chicago, Illinois, USA.
Current Opinion in Organ Transplantation
|July 29, 2026
Summary
Gut microbiota changes, or dysbiosis, can predict acute allograft rejection. Certain microbes and their metabolites may protect or harm transplanted organs, suggesting combined therapies could improve outcomes.
Area of Science:
- Microbiology
- Immunology
- Transplantation Science
Background:
- The gut microbiota plays a crucial role in modulating host immune responses.
- Dysbiosis, an imbalance in microbial communities, is increasingly linked to adverse outcomes in organ transplantation.
- Understanding the mechanistic links between microbiota and allograft rejection is vital for improving transplant success.
Purpose of the Study:
- To review recent advances in understanding the relationship between the gut microbiota and acute allograft rejection.
- To explore how microbial dysbiosis influences immune responses in the context of transplantation.
- To discuss potential therapeutic strategies targeting the microbiota to prevent or treat rejection.
Main Methods:
- Review of existing clinical and experimental studies investigating the gut microbiota in solid organ transplantation.
- Analysis of associations between microbial diversity, specific taxa, and metabolites with acute rejection.
- Examination of mechanistic insights from animal models elucidating the role of microbes in alloimmunity.
Main Results:
- Reduced gut microbial diversity and loss of short-chain fatty acid (SCFA)-producing bacteria are associated with acute rejection, sometimes preceding clinical diagnosis.
- Experimental models show certain bacterial strains and SCFA supplementation can enhance graft survival.
- Elevated levels of lysophosphatidic acid (LPA), a bacterial metabolite, correlate with rejection, indicating a complex microbial influence on alloimmune responses.
Conclusions:
- Microbial dysbiosis can precede acute allograft rejection, with specific microbial strains and metabolites exhibiting protective or detrimental effects.
- The microbiota's influence on different phases of the alloimmune response suggests that combinatorial therapeutic targeting of microbial axes may offer synergistic benefits.
- Modulating the gut microbiota presents a promising avenue for novel therapeutic interventions in solid organ transplantation.
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