Korean J Transplant.  2023 Nov;37(Suppl 1):S198. 10.4285/ATW2023.F-7872.

Impact of probiotic supplementation on kidney transplantation outcomes: a retrospective study

• Jang Y
• Kim Mg
• Koo TY
• Jun H
• Jung CW
• Oh YJ

• KMID: 2551818
• DOI: http://doi.org/10.4285/ATW2023.F-7872

Abstract

Background
The impact of probiotic supplementation in kidney transplantation (KT) recipients on immunosuppressants has not been extensively studies, resulting in limited evidence regarding its effects. As a result, the potential pros and cons of probiotics in this specific population have not been well-established. This study aims to investigate the effects of probiotic supplementation on KT outcomes.
Methods
We conducted a retrospective analysis of medical records of 378 KT recipients at Korea University Anam Hospital from January 2010 to December 2020. Only patients who had taken probiotics within a year post-KT were included, and transplant outcomes including graft function, infections, and cardiovascular events from 1 to 3 years after KT were evaluated.
Results
Of the 378 recipients (mean age, 47.5 years; female, 30.2%), 98 received probiotics during the study, with 36 taking them for over 3 months. Probiotic types included Lactobacillus spp. (44%), Bacillus subtilis (14%), and others (39%), and an average duration of supplementation was 104.8 days. The probiotics group showed no significant difference in estimated glomerular filtration rate at 1 year and 3 years compared to the nonprobiotics group. Cytomegalovirus viremia occurred in 127 patients, with a higher incidence in the probiotics group (52.0% vs. 27.1%). However, there was no significant difference in BK viremia or coronavirus disease 2019 infection. During the study period, 220 cases received antibiotics for more than 1 week, and the prevalence of bacterial infection was significantly greater in the probiotics group than in the nonprobiotics group (73.5% vs. 52.9%). Additionally, 21 patients experienced new onset cardiovascular disease, with a significantly higher incidence in the probiotics group.
Conclusions
Personalized probiotic supplementation for transplant recipients should be guided by existing evidence. Further randomized controlled trials are necessary to comprehensively understand its effects.