Changes in Oral and Gut Microbiota and Incidence and Severity of Patient-Reported Symptoms in Pre- and Post-Kidney Transplant Patients
- Principal Investigator
- Lockwood, Mark
- Funding Source
- Internal Research Support Program
This novel prospective pilot study will explore changes in the composition and function of the gut microbiome and relationships to symptom burden before and after patients receive a kidney transplant from a live donor. We have selected living donor recipients to reduce the chance of missing samples, as these are scheduled surgeries. Twenty subjects will provide stool and sputum samples for metagenomics microbiome analysis before transplant, during the first week after transplant, and at 3 months after the transplant. Demographic (age, gender, race/ethnicity, income, education) and disease specific data (HT/WT/BMI, creatinine, estimated glomerular filtration rate, basic metabolic panel, complete blood count), will be collected. Potential confounding variables to be assessed will include: historical use of antibiotics, concomitant medications, mode of delivery, and nutritional status. Symptom burden will be measured using the Modified Transplant Symptom Occurrence and Symptom Distress Scale (MTSOSDS). Additional assessment of symptoms and physical and emotional functioning will be conducted using the Patient Reported Outcome Measurement Systems (PROMIS-57). Health related quality of life will be assessed using the Kidney Disease Quality of Life Short Form (KDQOL-SF). Medication adherence will be treated as a covariate and will be continuously assessed using an electronic medication monitoring system, by monitoring immunosuppressant trough levels, and by monitoring immunosuppressant dose changes over the course of the study.