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Background <p>The urobiome of renal transplant recipients is poorly defined. The purpose of this study was to investigate whether there are characteristic changes in the urobiome between pre- to post-transplant states, at varying degrees of post-transplant allograft function, and between those with acute T-cell mediated rejection (TCMR) versus a non-rejector cohort.</p> Patients and methods <p>41 patients who consented to have urine stored in our transplant biobank were included in this study: 1) Rejectors (<i>n</i> = 10 pts: 6 borderline, 1 Banff IA, 3 Banff IIA TCMR, mean age: 47.4 ± 12.4 yrs); 2) Women (<i>n</i> = 16 pts; mean age: 49.3 ± 17.3 yrs); 3) Men (<i>n</i> = 15 pts, mean age: 47.5 ± 17.2 yrs). Urine was collected via mid-stream clean-catch technique prior to transplant (<i>n</i> = 21), at the time of TCMR (<i>n</i> = 9; within 1&#xa0;month of transplant), 1-month (<i>n</i> = 15), and 3-months post-transplant (<i>n</i> = 38). Samples were processed and stored at -80 <InlineEquation ID="IEq1"><EquationSource Format="TEX">\(^\circ{\rm C}\)</EquationSource></InlineEquation> until 16S rRNA sequencing. Alpha diversity, beta diversity, and differential abundance analysis was performed.</p> Results <p>The urobiome was altered post-transplant, with rejectors gaining <i>Corynebacterium</i> and <i>Pseudomonas</i> at time of rejection, and non-rejectors gaining <i>Lactobacillus</i> among other taxa. Within individuals, post-transplant urobiome composition was ~ 75% dissimilar from pre-transplant (<i>p</i> &lt; 0.001). Urobiome composition differed by sex (<i>p</i> = 0.002), but not by age. Differential abundance analysis based on 3-month post-transplant eGFR revealed consistent loss of <i>Lactobacillus</i> with decreased renal function.</p> Conclusions <p>Our results suggest that renal transplantation has a strong impact on individual urobiome composition, but not diversity, and microbial imbalance may be associated with acute rejection and post-transplant renal function. Our findings indicate a need for further research into the urobiome during renal transplantation to elucidate its potential as a biomarker of and/or contributor to post-transplant allograft health.</p>

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Urobiome composition after renal transplantation: an exploratory study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月2日

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  • David Harriman,
  • Alex Ng,
  • Monica Bronowski,
  • Ruixuan Yang,
  • Thien Dang,
  • Karen Sherwood,
  • Christopher Nguan,
  • Aaron Miller,
  • Dirk Lange

摘要

Background

The urobiome of renal transplant recipients is poorly defined. The purpose of this study was to investigate whether there are characteristic changes in the urobiome between pre- to post-transplant states, at varying degrees of post-transplant allograft function, and between those with acute T-cell mediated rejection (TCMR) versus a non-rejector cohort.

Patients and methods

41 patients who consented to have urine stored in our transplant biobank were included in this study: 1) Rejectors (n = 10 pts: 6 borderline, 1 Banff IA, 3 Banff IIA TCMR, mean age: 47.4 ± 12.4 yrs); 2) Women (n = 16 pts; mean age: 49.3 ± 17.3 yrs); 3) Men (n = 15 pts, mean age: 47.5 ± 17.2 yrs). Urine was collected via mid-stream clean-catch technique prior to transplant (n = 21), at the time of TCMR (n = 9; within 1 month of transplant), 1-month (n = 15), and 3-months post-transplant (n = 38). Samples were processed and stored at -80 \(^\circ{\rm C}\) until 16S rRNA sequencing. Alpha diversity, beta diversity, and differential abundance analysis was performed.

Results

The urobiome was altered post-transplant, with rejectors gaining Corynebacterium and Pseudomonas at time of rejection, and non-rejectors gaining Lactobacillus among other taxa. Within individuals, post-transplant urobiome composition was ~ 75% dissimilar from pre-transplant (p < 0.001). Urobiome composition differed by sex (p = 0.002), but not by age. Differential abundance analysis based on 3-month post-transplant eGFR revealed consistent loss of Lactobacillus with decreased renal function.

Conclusions

Our results suggest that renal transplantation has a strong impact on individual urobiome composition, but not diversity, and microbial imbalance may be associated with acute rejection and post-transplant renal function. Our findings indicate a need for further research into the urobiome during renal transplantation to elucidate its potential as a biomarker of and/or contributor to post-transplant allograft health.