MICROBIOTA IN ORGAN TRANSPLANTATION: THERAPEUTIC PERSPECTIVES AND MECHANISTIC INSIGHTS: Edited by Jerzy W. Kupiec-WeglinskiThe impact of the gut microbiome on liver transplantationDuong, Nikki; Bajaj, Jasmohan Singh Author Information Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University and Richmond VA Medical Center, Richmond, Virginia, USA Correspondence to Jasmohan Singh Bajaj, MD, Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University and Richmond VA Medical Center, 1201 Broad Rock Boulevard, Richmond, VA 23249, USA. Tel: +1 804 675 5802; fax: +1 804 675 5816; e-mail: [email protected] Current Opinion in Organ Transplantation: December 2021 - Volume 26 - Issue 6 - p 587-594 doi: 10.1097/MOT.0000000000000930 Buy Metrics Abstract Purpose of review Although gut dysbiosis can hasten disease progression in end-stage liver disease and contribute to disease severity, morbidity and mortality, its impact during and after transplant needs further study. Recent findings Changes in the microbiome are associated with hepatic decompensation. Immune homeostasis is further disrupted during transplant and with immunosuppressants required after transplant. There is increasing evidence of the role of microbiota in peri and posttransplant complications. Summary Although transplant is highly successful with acceptable survival rates, infections, rejection, disease recurrence and death remain important complications. Prognostication and interventions involving the gut microbiome could be beneficial. Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.