Trending ileal microbiome dysbiosis over time as an early assessment of intestinal transplant rejection risk
American Journal of Transplantation, 2026 (SCI-Expanded, Scopus)
- Publication Type: Article / Article
- Publication Date: 2026
- Doi Number: 10.1016/j.ajt.2026.07.007
- Journal Name: American Journal of Transplantation
- Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, MEDLINE, Health Research Premium Collection (ProQuest)
- Keywords: alpha diversity, beta diversity, Crohn's disease, intestinal transplantation, microbiome, rejection, relative abundance
- Hacettepe University Affiliated: Yes
Abstract
Rejection is a barrier to intestinal transplantation (ITx). ITx rejection may be associated with changes in the ileal microbiome. We sought to analyze whether shifts in the microbiome were associated with intestinal transplant rejection. Ileal effluent samples were collected from ITx patients (n = 8) with multiple samples taken from each patient at times of no (n = 83), mild (n = 39), or moderate (n = 3) rejection, Crohn’s disease (n = 20), and noninflamed control patients (n = 25). Ileal microbiota were quantified using 16S rRNA gene sequencing. Compared to nontransplant samples (noninflamed control, Crohn’s disease), ITx samples had lower alpha diversity (Shannon and Chao1, P < .001) and different beta diversity (Bray-Curtis, P < .005). Beta diversity differed between samples with and without rejection ( P = .002). Differential abundance analyses showed enrichment of pathogenic taxa and depletion of commensals in ITx rejection samples. ITx rejection is associated with ileal microbiome dysbiosis, which is a potential target for diagnostic and therapeutic interventions.