The Fecal Microbiome in Infants with Biliary Atresia Associates with Bile Flow after Kasai Portoenterostomy

Journal of Pediatric Gastroenterology and Nutrition
Mary Elizabeth M TessierBenjamin L Shneider

Abstract

Biliary atresia's (BA) response to surgical Kasai portoenterostomy (KP) is uneven and dependent upon bile flow; 50% of infants require a liver transplant by 24 months. We hypothesized that the microbiome may identify and associate with outcomes in BA. Stool samples were collected from infants with cholestasis (n = 15), 8 of which with BA were followed longitudinally.16S sequencing was performed on all samples (n = 45). Whole Genome Sequencing (WGS) was performed on BA pre-KP samples (n = 8). Infants with BA, other forms of cholestasis, BA infants with very good bile flow (VGBF) and not (nVGBF), (VGBF dichotomized by TSBA <40 μmol/L by 6 months) were compared. Of the 8 infants with BA, 4 infants had VGBF. Microbial richness was inversely proportional to degree of cholestasis (p = 0.046). Increased Bifidobacterium abundance associated with VGBF (p = 0.03) and decreased cholestasis (p < 0.01) at 1 month post-KP. Pre-KP, community structure differed in infants with BA vs other cholestasis. Interestingly, infants who subsequently achieved VGBF had increased diversity (p = 0.03) and different community structure at the pre-KP time point. WGS corroborated Bifidobacterium's pre-KP importance. The microbiome differs between infants with...Continue Reading

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Citations

Jan 12, 2021·Journal of Pediatric Gastroenterology and Nutrition·Vandana JainAnil Dhawan
Jul 17, 2021·Journal of Pediatric Gastroenterology and Nutrition·Daan van WesselJan Hulscher
Oct 21, 2021·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Julia M BosterShikha S Sundaram

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