- Prof. Thomas Fishbein, Principal Investigator
- Prof. Michael Zasloff, Co-Investigator
- Prof. Raffaele Girlanda, Co-Investigator
- Mrs Kate Levy, Research Associate
- Dr Aiyun Li, Research Associate
- Prof. Ramana Madupu, Collaborator
- MedStar Georgetown University Hospital, Washington DC, USA
- Does a Successful Intestinal Transplant Harbor a Special Population of Bacteria?
Intestinal transplantation is performed as a life-saving procedure, often to children born with congenital problems affecting their small or large intestine. These children are usually fed initially by intravenous solutions but eventually require a functional small intestine for adequate nutrition and normal growth. Although we have become increasingly more successful in our efforts to transplant the small intestine, rejection, failure of the graft, and death occur all too frequently. To monitor the health of the graft we must biopsy the patient very frequently (once totwice weekly for months), which requires that an “ostomy” be maintained to provide access to the interior of the graft. It would be of great value to have a non-invasive “biomarker” to assess the status of the allograft, such as exist for the kidney, bone marrow, and liver, where specific informative studies can be conducted on blood or urine. In this project we propose that a close examination of the microbes that normally reside in the intestine of the allograft along with the chemical compounds or “metabolites” they produce might serve that function. In other words, we examine samples of stool passed by the patient. We will use new powerful technologies to characterize both the “microbiome” (using advanced DNA sequencing) and “metabolome” (using advanced mass spectroscopy) of 1) recipients who have exhibited a stable engraftment and are 5 years out; 2) stable recipients, 1 year out; 3) recipients who are experiencing episodes of rejection, about 1 year out. We hope that these studies will provide new clinical tools to follow our transplant population and, in addition, provide insights into the relationship between the microbes that populate the transplanted gut and the overall outcome of the procedure.