Gut microbiota and complications in kidney transplantation: a balancing act between commensal and pathogenic bacteria.

PURPOSE OF REVIEW: Recent work has linked gut dysbiosis, an imbalance of commensal and pathogenic bacteria, to complications in kidney transplant recipients. The purpose of this review is to evaluate the gut microbiota's relationship to important complications in kidney transplantation. RECENT FINDINGS: In both allogeneic hematopoietic stem cell transplant and solid organ transplant recipients, gut dysbiosis has been linked to an increased risk of infections and higher mortality rates. In kidney transplant recipients, elevated intestinal uropathogen abundance is associated with development of urinary tract infection, and an imbalance between commensal and pathogenic bacteria has been linked to posttransplant diarrhea. SUMMARY: Gut dysbiosis with elevated abundance of pathogenic bacteria and decreased abundance of commensal bacteria is associated with urinary tract infections and posttransplant diarrhea in kidney transplantation.