The respiratory microbiome after lung transplantation: Reflection or driver of respiratory disease?

Am J Transplant. 2021 Jul;21(7):2333-2340. doi: 10.1111/ajt.16568. Epub 2021 Apr 16.

Abstract

With the introduction of high-throughput sequencing methods, our understanding of the human lower respiratory tract's inhabitants has expanded significantly in recent years. What is now termed the "lung microbiome" has been described for healthy patients, as well as people with chronic lung diseases and lung transplants. The lung microbiome of lung transplant recipients (LTRs) has proven to be unique compared with nontransplant patients, with characteristic findings associated with disease states, such as pneumonia, acute rejection, and graft failure. In this review, we summarize the current understanding of the lung microbiome in LTRs, not only focusing on bacteria but also highlighting key findings of the viral and the fungal community. Based on our knowledge of the lung microbiome in LTRs, we propose multiple opportunities for clinical use of the microbiome to improve outcomes in this population.

Keywords: infectious disease; lung transplantation/pulmonology; lung transplantation: living donor; microbiome; translational research/science.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Graft Rejection / etiology
  • Humans
  • Lung
  • Lung Diseases* / surgery
  • Lung Transplantation*
  • Microbiota*
  • Transplant Recipients