# Gut Microbiota in the Modulation of Outcomes after Liver Transplant

> **NIH NIH R21** · VIRGINIA COMMONWEALTH UNIVERSITY · 2021 · $236,219

## Abstract

Cirrhosis is a major cause of morbidity and mortality, and disease progression is associated with
altered gut microbial composition and function. The only reliable cure for cirrhosis is liver
transplant (LT). However, a sizable proportion of post-LT patients develop multi-drug resistant
organisms (MDROs), cognitive impairment and metabolic syndrome, which can be life-
threatening and result in long-term disability or incomplete recovery of pre-LT function.
Moreover, using currently available biomarkers, it is unclear which patients will develop these
post-LT adverse events and there is some evidence that altered gut microbiota plays an
important role. This proposal represents the first step towards using pre-LT microbial modulation
in preventing post-LT complications with the central hypothesis: Gut microbial composition
and function before liver transplant can successfully predict post-transplant outcomes.
We will study this hypothesis using the following specific aims:
Aim 1: To determine the role of pre-transplant gut microbial composition and function in
the prediction of post-transplant infections through MDRO colonization,
Aim 2: To determine the role of pre-transplant gut microbial composition and function in
the development of post-transplant metabolic syndrome,
Aim 3: To determine the role of pre-transplant gut microbial composition and function in
cognitive recovery after liver transplant
The study will have 2 parts: Part 1 will utilize already collected longitudinal samples from 150 LT
recipients from both centers. Part 2 will enroll 50 more patients per site to validate findings from
part 1. Stool microbiota composition (16srRNA sequencing for diversity, relative abundance of
potentially pathogenic and beneficial taxa, and specific molecular assays for MDRO
colonization) and function (metabolomics, bile acids) will be performed. Cognitive function
(validated paper-pencil and computerized techniques) and metabolic syndrome will be
diagnosed post-LT. Pre-transplant microbial assessment will be used to predict these outcomes
independent of already validated clinical predictors using bio-informatics. This will help guide
future precision medicine based research on microbiota in prognosticating LT patients.
The CTSAs at VCU and CUIMC are associated with leading LT centers with a long track record
of clinical and translational research in cirrhosis, liver transplant, microbiota, and cognition. Both
centers will collaborate equally in recruitment and analysis. This proposal fits with PAR-19-100
through the focus on Precision Medicine and Translational studies of the human microbiome.

## Key facts

- **NIH application ID:** 10231248
- **Project number:** 5R21TR003095-02
- **Recipient organization:** VIRGINIA COMMONWEALTH UNIVERSITY
- **Principal Investigator:** Jasmohan S Bajaj
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $236,219
- **Award type:** 5
- **Project period:** 2020-08-07 → 2024-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10231248

## Citation

> US National Institutes of Health, RePORTER application 10231248, Gut Microbiota in the Modulation of Outcomes after Liver Transplant (5R21TR003095-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10231248. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*