{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T11:14:20Z","timestamp":1789470860676,"version":"build-2803163510"},"reference-count":32,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T00:00:00Z","timestamp":1781827200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Microbiol."],"abstract":"<jats:p>Liver transplantation (LT) is a critical intervention for end-stage liver disease, while complications, such as infections, graft rejection, and metabolic disturbances are common post-transplant. The gut microbiota-bile acid (GM-BA) axis plays a pivotal role in regulating liver function and overall health, influencing both the gut microbiota and bile acid metabolism. This review explored the complex interplay between the gut microbiota (GM) and bile acids during liver transplantation. It also discussed how disruptions in this axis can lead to post-transplant complications, such as infection, rejection, and liver injury. Specifically, the role of microbiota-derived bile acids was assessed in shaping immune responses and metabolic pathways that may impact liver graft function. Furthermore, therapeutic strategies aimed at modulating the GM-BA axis were reviewed to improve post-transplant outcomes, including the use of probiotics, prebiotics, and bile acid receptor modulators. Understanding the mechanisms behind GM-BA dysregulation may provide new directions for improving liver transplant survival and reducing complications.<\/jats:p>","DOI":"10.3389\/fmicb.2026.1832332","type":"journal-article","created":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T05:46:22Z","timestamp":1781847982000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["The gut microbiota-bile acid axis in liver transplantation: implications for postoperative complications and therapeutic strategies"],"prefix":"10.3389","volume":"17","author":[{"given":"Churui","family":"Xia","sequence":"first","affiliation":[{"name":"Zhejiang Chinese Medical University","place":["Hangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenjin","family":"Zhang","sequence":"additional","affiliation":[{"name":"Zhejiang Chinese Medical University","place":["Hangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ten","family":"Fang","sequence":"additional","affiliation":[{"name":"Hangzhou Normal University","place":["Hangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Longjie","family":"Yu","sequence":"additional","affiliation":[{"name":"Zhejiang University School of Medicine","place":["Hangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daijun","family":"Yu","sequence":"additional","affiliation":[{"name":"Zhejiang Chinese Medical University","place":["Hangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wu","family":"Zhang","sequence":"additional","affiliation":[{"name":"Zhejiang Shuren University Key Laboratory of Artificial Organs and Computational Medicine","place":["Hangzhou, China"]},{"name":"Shulan Hangzhou Hospital Affiliated to Zhejiang Shuren University Shulan International Medical College","place":["Hangzhou, China"]},{"name":"Zhejiang Shuren University Shulan International Medical College","place":["Hangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,19]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1792","DOI":"10.3390\/biomedicines11071792","article-title":"Gut microbiota and liver transplantation: immune mechanisms behind the rejection","volume":"11","author":"Abenavoli","year":"2023","journal-title":"Biomedicines"},{"key":"B2","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1016\/j.jceh.2024.102189","article-title":"FXR agonist in post-liver transplantation patients: a randomized open-labeled study","volume":"14","author":"Anila","year":"2025","journal-title":"F1000Research"},{"key":"B3","doi-asserted-by":"publisher","first-page":"eadm8841","DOI":"10.1126\/sciadv.adm8841","article-title":"Spatially resolved immune exhaustion within the alloreactive microenvironment predicts liver transplant rejection","volume":"10","author":"Barbetta","year":"2024","journal-title":"Sci Adv."},{"key":"B4","doi-asserted-by":"publisher","first-page":"101039","DOI":"10.1016\/j.jhepr.2024.101039","article-title":"Gut microbiome dynamics and Enterobacterales infection in liver transplant recipients: a prospective observational study","volume":"6","author":"D'Amico","year":"2024","journal-title":"JHEP Rep"},{"key":"B5","doi-asserted-by":"publisher","first-page":"2460543","DOI":"10.1080\/19490976.2025.2460543","article-title":"Lachnospiraceae-bacterium alleviates ischemia-reperfusion injury in steatotic donor liver by inhibiting ferroptosis via the Foxo3-Alox15 signaling pathway","volume":"17","author":"Deng","year":"2025","journal-title":"Gut Microbes"},{"key":"B6","doi-asserted-by":"publisher","first-page":"719","DOI":"10.1038\/s41579-023-00904-3","article-title":"The gut-liver axis and gut microbiota in health and liver disease","volume":"21","author":"Hsu","year":"2023","journal-title":"Nat. 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