Bile Microbiota in Liver Transplantation: Proof of Concept Using Gene Amplification in a Heterogeneous Clinical Scenario

Francesco D'Amico; Alessandra Bertacco; Michele Finotti; Chiara Di Renzo; Manuel I Rodriguez-Davalos; Gabriel E Gondolesi; Umberto Cillo; David Mulligan; John Geibel

doi:10.3389/fsurg.2021.621525

Bile Microbiota in Liver Transplantation: Proof of Concept Using Gene Amplification in a Heterogeneous Clinical Scenario

Front Surg. 2021 Mar 16:8:621525. doi: 10.3389/fsurg.2021.621525. eCollection 2021.

Authors

Affiliations

¹ Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Oncology and Gastroenterology, Padua University, Padua, Italy.
² Transplantation and Immunology Section, Department of Surgery, Yale University, New Haven, CT, United States.
³ Transplantation Unit, Intermountain Medical Center, University of Utah, Salt Lake City, UT, United States.
⁴ General Surgery and Multivisceral Transplantation Unit, Department of Surgery, Buenos Aires University, Buenos Aires, Argentina.

Abstract

Objective: Historically, bile in the biliary tract has been considered sterile. Most of the series are based on patients with biliary tract diseases or the bile has been obtained with procedures susceptible to contamination. Methods: We evaluated the bile in a heterogeneous cohort of liver donors and recipient patients, with samples obtained in a sterile way, directly from the gallbladder and the common bile duct. Results: We assessed the bile microbiota in six liver donors and in six liver recipients after whole or split liver procedures in adult or pediatric recipients. Bile samples were studied using PCR sequencing of the 16S ribosomal RNA gene amplification (rDNA). Conclusions: We demonstrated that the bile is sterile, thereby ruling this out as a source of contamination following transplant.

Keywords: 16S ribosomal RNA gene amplification; biliary infections; gallbladder; microbiome; rDNA sequence analysis.