{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T01:47:07Z","timestamp":1782352027596,"version":"3.54.5"},"reference-count":134,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T00:00:00Z","timestamp":1782259200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background: Kidney transplantation is the preferred treatment for end-stage kidney disease (ESKD), but long-term outcomes remain limited by chronic allograft injury, infections, metabolic complications, and cardiovascular risk. Gut microbiota alterations and microbiota-derived metabolites may influence immune regulation, inflammation, drug metabolism, and graft outcomes through the gut\u2013kidney axis. This review summarizes evidence on the gut microbiota in kidney transplantation, emphasizing immune tolerance, complications, cardiovascular risk, graft function, and perspectives. Methods: A structured search was conducted in PubMed, Scopus, and Web of Science to May 2026. Eligible publications included studies involving kidney transplant recipients (KTR), kidney disease or solid organ transplant populations, and mechanistic models. Evidence was synthesized narratively. Results: Gut microbiota alterations in KTR reflect pre-transplant dysbiosis and post-transplant exposures, including antibiotics, immunosuppression, infection, diet, hospitalization, and graft function. Dietary factors and nutrient-derived substrates may modulate microbial composition and production of relevant metabolites, including short-chain fatty acids (SCFAs), trimethylamine N-oxide (TMAO), tryptophan-derived compounds, bile acid derivatives, and uremic toxins. Microbiota-related pathways may involve barrier dysfunction, microbial translocation, innate immune activation, altered regulatory T cell\/T helper 17 (Treg\/Th17) balance, metabolite signaling, uremic toxin generation, and endothelial stress. Clinical studies associate dysbiosis and microbial metabolites with diarrhea, infections, delayed graft function (DGF), rejection-related shifts, tacrolimus variability, cardiovascular risk, graft dysfunction, graft failure, and mortality. Most findings need validation. Conclusions: Gut microbiota signatures and microbial metabolites are promising markers of transplant-related risk, but not established causal determinants or therapeutic targets. Clinical translation requires standardized methods, multi-omics integration, and prospective patient- and graft-centered trials.<\/jats:p>","DOI":"10.3390\/nu18132056","type":"journal-article","created":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T01:03:56Z","timestamp":1782349436000},"page":"2056","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Kidney Transplantation and the Gut\u2013Kidney Axis: Microbial, Metabolic, and Nutritional Implications for Graft and Patient Outcomes"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-3793-0372","authenticated-orcid":false,"given":"Leon","family":"Sm\u00f3\u0142ka","sequence":"first","affiliation":[{"name":"Student Scientific Association, Department of Internal, Metabolic Diseases and Angiology, Faculty of Health Sciences, Medical University of Silesia, Ziolowa 45\/47 St., 40-635 Katowice, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-8281-7490","authenticated-orcid":false,"given":"Mi\u0142osz","family":"Struga\u0142a","sequence":"additional","affiliation":[{"name":"Student Scientific Association, Department of Internal, Metabolic Diseases and Angiology, Faculty of Health Sciences, Medical University of Silesia, Ziolowa 45\/47 St., 40-635 Katowice, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-7328-8509","authenticated-orcid":false,"given":"Karolina","family":"Kursa","sequence":"additional","affiliation":[{"name":"Student Scientific Association, Department of Internal, Metabolic Diseases and Angiology, Faculty of Health Sciences, Medical University of Silesia, Ziolowa 45\/47 St., 40-635 Katowice, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-0728-3751","authenticated-orcid":false,"given":"Karolina","family":"Blady","sequence":"additional","affiliation":[{"name":"Student Scientific Association, Department of Internal, Metabolic Diseases and Angiology, Faculty of Health Sciences, Medical University of Silesia, Ziolowa 45\/47 St., 40-635 Katowice, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6939-9898","authenticated-orcid":false,"given":"Agata","family":"Stanek","sequence":"additional","affiliation":[{"name":"Department of Internal, Metabolic Diseases and Angiology, Faculty of Health Sciences, Medical University of Silesia, Ziolowa 45\/47 St., 40-635 Katowice, Poland"},{"name":"Upper Silesian Medical Center, Medical University of Silesia, Ziolowa 45\/47 St., 40-635 Katowice, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"sfae214","DOI":"10.1093\/ckj\/sfae214","article-title":"Kidney Transplantation and Gut Microbiota","volume":"17","author":"Chen","year":"2024","journal-title":"Clin. Kidney J."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"97458","DOI":"10.5500\/wjt.v15.i1.97458","article-title":"Endothelial Dysfunction in the Kidney Transplant Population: Current Evidence and Management Strategies","volume":"15","author":"Prabhahar","year":"2025","journal-title":"World J. Transplant."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Garc\u00eda-Mart\u00ednez, Y., Borriello, M., Capolongo, G., Ingrosso, D., and Perna, A.F. (2023). The Gut Microbiota in Kidney Transplantation: A Target for Personalized Therapy?. Biology, 12.","DOI":"10.3390\/biology12020163"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2642487","DOI":"10.1080\/0886022X.2026.2642487","article-title":"Targeting the Gut-Kidney Axis to Improve Kidney Transplantation Prognosis: From Mechanisms to Clinical Intervention Strategies","volume":"48","author":"Cao","year":"2026","journal-title":"Ren. Fail."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"570","DOI":"10.1097\/MNH.0000000000000262","article-title":"Current Status of the Microbiome in Renal Transplantation","volume":"25","author":"Ahmad","year":"2016","journal-title":"Curr. Opin. Nephrol. Hypertens."},{"key":"ref_6","first-page":"e947197","article-title":"Serum Trimethylamine N-Oxide Levels as a Predictor of Peripheral Arterial Disease in Kidney Transplant Recipients","volume":"31","author":"Yang","year":"2025","journal-title":"Med. Sci. Monit."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1643","DOI":"10.1016\/j.ajt.2025.02.010","article-title":"Gut Microbiome Alterations Precede Graft Rejection in Kidney Transplantation Patients","volume":"25","author":"Holle","year":"2025","journal-title":"Am. J. Transplant."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Souza, C.S., Camara, N.O.S., and Alves-Silva, T. (2026). Microbiota Management: A Perspective for Kidney Transplant Patients. Front. Transplant., 5.","DOI":"10.3389\/frtra.2026.1703048"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"44709","DOI":"10.1038\/s41598-025-28725-9","article-title":"Gut Microbiome and Metabolite Signatures for Predicting Acute Kidney Transplant Rejection: A Prospective Study","volume":"15","author":"Cho","year":"2025","journal-title":"Sci. Rep."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Lee, J.R., Muthukumar, T., Dadhania, D., Taur, Y., Jenq, R.R., Toussaint, N.C., Ling, L., Pamer, E., and Suthanthiran, M. (2015). Gut Microbiota and Tacrolimus Dosing in Kidney Transplantation. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0122399"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"100668","DOI":"10.1016\/j.trre.2021.100668","article-title":"Impact of gut microbiota on kidney transplantation","volume":"36","author":"Winichakoon","year":"2022","journal-title":"Transplant. Rev."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1038\/s41579-025-01271-x","article-title":"The gut microbiome in solid-organ and haematopoietic stem cell transplantation","volume":"24","author":"Swarte","year":"2026","journal-title":"Nat. Rev. Microbiol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1038\/ki.2012.345","article-title":"Chronic kidney disease alters intestinal microbial flora","volume":"83","author":"Vaziri","year":"2013","journal-title":"Kidney Int."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2001936","DOI":"10.1002\/advs.202001936","article-title":"Alterations of the Human Gut Microbiome in Chronic Kidney Disease","volume":"7","author":"Ren","year":"2020","journal-title":"Adv. Sci."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"958","DOI":"10.1038\/ki.2015.255","article-title":"Probiotics and Chronic Kidney Disease","volume":"88","author":"Koppe","year":"2015","journal-title":"Kidney Int."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Rysz, J., Franczyk, B., \u0141awi\u0144ski, J., Olszewski, R., Cia\u0142kowska-Rysz, A., and Gluba-Brz\u00f3zka, A. (2021). The Impact of CKD on Uremic Toxins and Gut Microbiota. Toxins, 13.","DOI":"10.3390\/toxins13040252"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Voroneanu, L., Covic, A., Iliescu, S., Baluta, C.V., Agavriloaei, B.D., Stefan, A.E., Am\u0103randi, R.M., V\u0103c\u0103rean-Trandafir, I.C., Ivanov, I.C., and Covic, A. (2025). Distinct Gut Microbiome Signatures in Hemodialysis and Kidney Transplant Populations. J. Clin. Med., 14.","DOI":"10.3390\/jcm14228032"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Lim, X., Ooi, L., Ding, U., Wu, H.H.L., and Chinnadurai, R. (2024). Gut Microbiota in Patients Receiving Dialysis: A Review. Pathogens, 13.","DOI":"10.3390\/pathogens13090801"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"416","DOI":"10.1111\/ajt.12588","article-title":"Human Microbiota Characterization in the Course of Renal Transplantation","volume":"14","author":"Fricke","year":"2014","journal-title":"Am. J. Transplant."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Swarte, J.C., Douwes, R.M., Hu, S., Vich Vila, A., Eisenga, M.F., van Londen, M., Gomes-Neto, A.W., Weersma, R.K., Harmsen, H.J.M., and Bakker, S.J.L. (2020). Characteristics and Dysbiosis of the Gut Microbiome in Renal Transplant Recipients. J. Clin. Med., 9.","DOI":"10.3390\/jcm9020386"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"eabn7566","DOI":"10.1126\/scitranslmed.abn7566","article-title":"Gut microbiome dysbiosis is associated with increased mortality after solid organ transplantation","volume":"14","author":"Swarte","year":"2022","journal-title":"Sci. Transl. Med."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"2977","DOI":"10.1007\/s40620-025-02439-7","article-title":"The Capacity of Gastrointestinal Microbiota in Kidney Transplant Recipients to Ferment Prebiotic Starch","volume":"38","author":"Choo","year":"2025","journal-title":"J. Nephrol."},{"key":"ref_23","first-page":"41","article-title":"\u010crevn\u00fd Mikrobi\u00f3m a Transplant\u00e1cia Obli\u010dky (Gut Microbiome and Renal Transplantation)","volume":"69","year":"2023","journal-title":"Vnitr. Lek."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Fusco, W., Lorenzo, M.B., Cintoni, M., Porcari, S., Rinninella, E., Kaitsas, F., Lener, E., Mele, M.C., Gasbarrini, A., and Collado, M.C. (2023). Short-Chain Fatty-Acid-Producing Bacteria: Key Components of the Human Gut Microbiota. Nutrients, 15.","DOI":"10.3390\/nu15092211"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"488","DOI":"10.1111\/ajt.14974","article-title":"Gut Microbiota Dysbiosis and Diarrhea in Kidney Transplant Recipients","volume":"19","author":"Lee","year":"2019","journal-title":"Am. J. Transplant."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Dudzicz-Gojowy, S., Wi\u0119cek, A., and Adamczak, M. (2022). Clostridioides difficile Infection in Patients after Organ Transplantation\u2014A Narrative Overview. J. Clin. Med., 11.","DOI":"10.3390\/jcm11154365"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Nambiar, P., Silibovsky, R., and Belden, K.A. (2018). Infection in Kidney Transplantation. Contemporary Kidney Transplantation, Springer.","DOI":"10.1007\/978-3-319-19617-6_22"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Ding, U., Ooi, L., Wu, H.H.L., and Chinnadurai, R. (2024). Clostridioides difficile Infection in Kidney Transplant Recipients. Pathogens, 13.","DOI":"10.3390\/pathogens13020140"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Li, Y., Yang, Y., Yang, N., Wu, Q., Yang, J., Guo, J., and Zhang, H. (2024). Recent Advances in Fecal Microbiota Transplantation for Clostridium difficile Infection-Associated Diarrhea After Kidney Transplantation. Front. Microbiomes, 3.","DOI":"10.3389\/frmbi.2024.1409967"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"781","DOI":"10.1177\/03915603241276742","article-title":"Gut Microbiota Alterations in Renal Transplant Recipients and the Risk of Urinary Tract Infection and Delayed Graft Function: A Preliminary Prospective Study","volume":"91","author":"Moghaddam","year":"2024","journal-title":"Urologia"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1016\/j.aju.2012.01.005","article-title":"Urinary Tract Infection in Renal Transplantation","volume":"10","author":"Giessing","year":"2012","journal-title":"Arab J. Urol."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Go\u0142\u0119biewska, J.E., Krawczyk, B., Wysocka, M., Dudziak, A., and D\u0119bska-\u015alizie\u0144, A. (2023). Asymptomatic Bacteriuria in Kidney Transplant Recipients\u2014A Narrative Review. Medicina, 59.","DOI":"10.3390\/medicina59020198"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1016\/j.biopha.2017.02.114","article-title":"Gut Microbiota and Renal Transplant Outcome","volume":"90","author":"Ardalan","year":"2017","journal-title":"Biomed. Pharmacother."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1445","DOI":"10.1681\/ASN.2019080852","article-title":"Gut Microbial Metabolites Induce Donor-Specific Tolerance of Kidney Allografts through Induction of T Regulatory Cells by Short-Chain Fatty Acids","volume":"31","author":"Wu","year":"2020","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"582","DOI":"10.1097\/MOT.0000000000000921","article-title":"New Insights into the Microbiome in Kidney Transplantation","volume":"26","author":"Kim","year":"2021","journal-title":"Curr. Opin. Organ Transplant."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"580","DOI":"10.32394\/pe\/214773","article-title":"The Impact of the Gut Microbiome on the Development of Atherosclerosis and Peripheral Arterial Disease: A Narrative Review","volume":"79","author":"Kursa","year":"2025","journal-title":"Przegl. Epidemiol."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Sm\u00f3\u0142ka, L., Struga\u0142a, M., Blady, K., Kursa, K., Pomianowski, B., and Stanek, A. (2026). Venous Thromboembolism and Gut Dysbiosis: Mechanistic Links Between Endotoxemia, Microbial Metabolites, and Thromboinflammation. Nutrients, 18.","DOI":"10.3390\/nu18081231"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"4164","DOI":"10.1038\/s41467-025-59550-3","article-title":"Structural Insight into TLR4\/MD-2 Activation by Synthetic LPS Mimetics with Distinct Binding Modes","volume":"16","author":"Fu","year":"2025","journal-title":"Nat. Commun."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Xie, H., Yu, S., Tang, M., Xun, Y., Shen, Q., and Wu, G. (2025). Gut Microbiota Dysbiosis in Inflammatory Bowel Disease: Interaction with Intestinal Barriers and Microbiota-Targeted Treatment Options. Front. Cell. Infect. Microbiol., 15.","DOI":"10.3389\/fcimb.2025.1608025"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"329405","DOI":"10.1155\/2015\/329405","article-title":"Effect of TLR4\/MyD88 Signaling Pathway on Expression of IL-1\u03b2 and TNF-\u03b1 in Synovial Fibroblasts from Temporomandibular Joint Exposed to Lipopolysaccharide","volume":"2015","author":"Lin","year":"2015","journal-title":"Mediat. Inflamm."},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Hasan, A., Akhter, N., Al-Roub, A., Thomas, R., Kochumon, S., Wilson, A., Koshy, M., Al-Ozairi, E., Al-Mulla, F., and Ahmad, R. (2019). TNF-\u03b1 in Combination with Palmitate Enhances IL-8 Production via The MyD88- Independent TLR4 Signaling Pathway: Potential Relevance to Metabolic Inflammation. Int. J. Mol. Sci., 20.","DOI":"10.3390\/ijms20174112"},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Hu, L., Cheng, Z., Chu, H., Wang, W., Jin, Y., and Yang, L. (2024). TRIF-Dependent Signaling and Its Role in Liver Diseases. Front. Cell Dev. Biol., 12.","DOI":"10.3389\/fcell.2024.1370042"},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Mohammad, S., and Thiemermann, C. (2021). Role of Metabolic Endotoxemia in Systemic Inflammation and Potential Interventions. Front. Immunol., 11.","DOI":"10.3389\/fimmu.2020.594150"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1053\/j.ajkd.2015.09.027","article-title":"Role of the Gut Microbiome in Uremia: A Potential Therapeutic Target","volume":"67","author":"Ramezani","year":"2016","journal-title":"Am. J. Kidney Dis."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Ma, L., Zhang, H., Hu, K., Lv, G., Fu, Y., Ayana, D.A., Zhao, P., and Jiang, Y. (2015). The Imbalance Between Tregs, Th17 Cells and Inflammatory Cytokines Among Renal Transplant Recipients. BMC Immunol., 16.","DOI":"10.1186\/s12865-015-0118-8"},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Koshida, K., Ito, M., Yakabe, K., Takahashi, Y., Tai, Y., Akasako, R., Kimizuka, T., Takano, S., Sakamoto, N., and Haniuda, K. (2023). Dysfunction of Foxp3+ Regulatory T Cells Induces Dysbiosis of Gut Microbiota via Aberrant Binding of Immunoglobulins to Microbes in the Intestinal Lumen. Int. J. Mol. Sci., 24.","DOI":"10.3390\/ijms24108549"},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Andrzejczak, K., Kucharczyk, E., Sternak, A., Bus\u0142owicz, T., and Ponikowska, M. (2026). Gut Dysbiosis and the Molecular Landscape of the Gut\u2013Skin Axis: Comparative Insights and Therapeutic Implications for Atopic Dermatitis and Psoriasis. Cells, 15.","DOI":"10.3390\/cells15070594"},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Hu, Y., Yang, Y., Li, Y., Zhang, Q., Zhang, W., Jia, J., Han, Z., and Wang, J. (2025). Th17\/Treg Imbalance in Inflammatory Bowel Disease: Immunological Mechanisms and Microbiota-Driven Regulation. Front. Immunol., 16.","DOI":"10.3389\/fimmu.2025.1651063"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"7968","DOI":"10.1038\/s41467-023-43431-8","article-title":"Health-Related Quality of Life Is Linked to the Gut Microbiome in Kidney Transplant Recipients","volume":"14","author":"Swarte","year":"2023","journal-title":"Nat. Commun."},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Ferris, M.M., Subitoni, A.L., and Al-Sadi, R. (2025). Probiotics and the Intestinal Tight Junction Barrier Function. Front. Cell Dev. Biol., 13.","DOI":"10.3389\/fcell.2025.1671152"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"2077620","DOI":"10.1080\/21688370.2022.2077620","article-title":"Tight Junctions: From Molecules to Gastrointestinal Diseases","volume":"11","author":"Moonwiriyakit","year":"2023","journal-title":"Tissue Barriers"},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"James, P., Stanford, J., Dixit, O.V.A., Nicdao, M.A., McWhinney, B., Sud, K., Ryan, M., Read, S., Ahlenstiel, G., and Lambert, K. (2025). Associations Between Uraemic Toxins and Gut Microbiota in Adults Initiating Peritoneal Dialysis. Toxins, 17.","DOI":"10.3390\/toxins17070334"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1038\/nrneph.2017.30","article-title":"Metabolomics for Clinical Use and Research in Chronic Kidney Disease","volume":"13","author":"Hocher","year":"2017","journal-title":"Nat. Rev. Nephrol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"16035","DOI":"10.1038\/sigtrans.2016.35","article-title":"Butyrate Induces Apoptosis by Activating PDC and Inhibiting Complex I Through SIRT3 Inactivation","volume":"2","author":"Xu","year":"2017","journal-title":"Signal Transduct. Target. Ther."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"2819","DOI":"10.1038\/s41598-022-27086-x","article-title":"Inhibition of Inflammatory Microglia by Dietary Fiber and Short-Chain Fatty Acids","volume":"13","author":"Rund","year":"2023","journal-title":"Sci. Rep."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"152398","DOI":"10.1016\/j.seminoncol.2025.152398","article-title":"The Effects of Microbiota-Derived Short-Chain Fatty Acids on T Lymphocytes: From Autoimmune Diseases to Cancer","volume":"52","author":"Saadh","year":"2025","journal-title":"Semin. Oncol."},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"Kalkan, A.E., BinMowyna, M.N., Raposo, A., Ahmad, M.F., Ahmed, F., Otayf, A.Y., Carrascosa, C., Saraiva, A., and Karav, S. (2025). Beyond the Gut: Unveiling Butyrate\u2019s Global Health Impact Through Gut Health and Dysbiosis-Related Conditions: A Narrative Review. Nutrients, 17.","DOI":"10.3390\/nu17081305"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1016\/j.clnu.2022.10.024","article-title":"Butyrate\u2019s Role in Human Health and the Current Progress Towards Its Clinical Application to Treat Gastrointestinal Disease","volume":"42","author":"Hodgkinson","year":"2023","journal-title":"Clin. Nutr."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"100316","DOI":"10.1016\/j.jtauto.2025.100316","article-title":"Short-Chain Fatty Acids from Gut Microbiota Restore Th17\/Treg Balance in Rheumatoid Arthritis: Mechanisms and Therapeutic Potential","volume":"11","author":"Pang","year":"2025","journal-title":"J. Transl. Autoimmun."},{"key":"ref_60","doi-asserted-by":"crossref","unstructured":"Naito, K., Tomii, A., Ishii, K., and Shimizu, H. (2026). Indole-3-Acetic Acid and Skatole Exert Opposing Effects on MDR1 Proteostasis in Human Colonic Epithelial Cells: A Molecular Basis for the Gut Microbial Metabolic Switch. J. Xenobiot., 16.","DOI":"10.3390\/jox16010036"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1038\/cr.2008.63","article-title":"The Aryl Hydrocarbon Receptor: A Regulator of Th17 and Treg Cell Development in Disease","volume":"18","author":"Ho","year":"2008","journal-title":"Cell Res."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1186\/s40168-023-01486-1","article-title":"IL-22 Alters Gut Microbiota Composition and Function to Increase Aryl Hydrocarbon Receptor Activity in Mice and Humans","volume":"11","author":"Mar","year":"2023","journal-title":"Microbiome"},{"key":"ref_63","doi-asserted-by":"crossref","unstructured":"Song, G., Xie, Y., Yi, L., Cheng, W., Jia, H., Shi, W., Liu, Q., Fang, L., Xue, S., and Liu, D. (2025). Bile Acids Affect Intestinal Barrier Function Through FXR and TGR5. Front. Med., 12.","DOI":"10.3389\/fmed.2025.1607899"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1038\/s41586-019-1785-z","article-title":"Bile Acid Metabolites Control Th17 and Treg Cell Differentiation","volume":"576","author":"Hang","year":"2019","journal-title":"Nature"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"402","DOI":"10.1007\/s00253-024-13236-w","article-title":"Prediction of Delayed Graft Function by Early Salivary Microbiota Following Kidney Transplantation","volume":"108","author":"Xiang","year":"2024","journal-title":"Appl. Microbiol. Biotechnol."},{"key":"ref_66","doi-asserted-by":"crossref","unstructured":"Jardou, M., Provost, Q., Brossier, C., Pinault, \u00c9., Sauvage, F.L., and Lawson, R. (2021). Alteration of the Gut Microbiome in Mycophenolate-Induced Enteropathy: Impacts on the Profile of Short-Chain Fatty Acids in a Mouse Model. BMC Pharmacol. Toxicol., 22.","DOI":"10.1186\/s40360-021-00536-4"},{"key":"ref_67","doi-asserted-by":"crossref","unstructured":"Lim, Y.J., Sidor, N.A., Tonial, N.C., Che, A., and Urquhart, B.L. (2021). Uremic Toxins in the Progression of Chronic Kidney Disease and Cardiovascular Disease: Mechanisms and Therapeutic Targets. Toxins, 13.","DOI":"10.3390\/toxins13020142"},{"key":"ref_68","doi-asserted-by":"crossref","unstructured":"Mishima, E., and Abe, T. (2022). Gut Microbiota Dynamics and Uremic Toxins. Toxins, 14.","DOI":"10.3390\/toxins14020146"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1007\/s00018-024-05532-5","article-title":"Gut Microbiota Regulates Oxidative Stress and Inflammation: A Double-Edged Sword in Renal Fibrosis","volume":"81","author":"Li","year":"2024","journal-title":"Cell Mol. Life Sci."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1111\/tri.12413","article-title":"Cardiovascular Morbidity and Mortality after Kidney Transplantation","volume":"28","author":"Stoumpos","year":"2015","journal-title":"Transpl. Int."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1016\/j.semnephrol.2018.02.008","article-title":"Cardiovascular Disease After Kidney Transplant","volume":"38","author":"Rao","year":"2018","journal-title":"Semin. Nephrol."},{"key":"ref_72","doi-asserted-by":"crossref","unstructured":"Reggiani, F., Moroni, G., and Ponticelli, C. (2022). Cardiovascular Risk after Kidney Transplantation: Causes and Current Approaches to a Relevant Burden. J. Pers. Med., 12.","DOI":"10.3390\/jpm12081200"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"998","DOI":"10.1093\/ndt\/gfaf239","article-title":"New Kidneys, Old Risks: Cardiovascular Challenges After Transplantation","volume":"41","author":"Chinnappa","year":"2026","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1080\/14779072.2025.2520832","article-title":"Understanding Endothelial Dysfunction in Kidney Transplantation: Assessment Techniques, Existing Evidence, and Research Needs","volume":"23","author":"Iatridi","year":"2025","journal-title":"Expert Rev. Cardiovasc. Ther."},{"key":"ref_75","doi-asserted-by":"crossref","unstructured":"Kensinger, C., Bian, A., Fairchild, M., Chen, G., Lipworth, L., Ikizler, T.A., and Birdwell, K.A. (2016). Long Term Evolution of Endothelial Function During Kidney Transplantation. BMC Nephrol., 17.","DOI":"10.1186\/s12882-016-0369-5"},{"key":"ref_76","doi-asserted-by":"crossref","unstructured":"Junarta, J., Hojs, N., Ramphul, R., Lowe-Jones, R., Kaski, J.C., and Banerjee, D. (2020). Progression of Endothelial Dysfunction, Atherosclerosis, and Arterial Stiffness in Stable Kidney Transplant Patients: A Pilot Study. BMC Cardiovasc. Disord., 20.","DOI":"10.1186\/s12872-019-01309-y"},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"e01026010","DOI":"10.5603\/aa.104579","article-title":"Ultrasonographic Assessment of Carotid Artery Intima-Media Thickness as a Predictive Factor for Cardiovascular Events in Young Adults","volume":"32","author":"Blady","year":"2026","journal-title":"Acta Angiol."},{"key":"ref_78","doi-asserted-by":"crossref","unstructured":"Sm\u00f3\u0142ka, L., Struga\u0142a, M., Blady, K., Pomianowski, B., Kursa, K., and Stanek, A. (2026). Pathogenetic Gut Microbiota in Aortic Diseases: Evidence and Mechanisms Across Aneurysm, Dissection, and Inflammatory Aortopathies. Nutrients, 18.","DOI":"10.3390\/nu18040565"},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"e007235","DOI":"10.1161\/JAHA.117.007235","article-title":"Reduction of Arterial Stiffness After Kidney Transplantation: A Systematic Review and Meta-Analysis","volume":"6","author":"Fortier","year":"2017","journal-title":"J. Am. Heart Assoc."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"1730","DOI":"10.1097\/TP.0000000000000660","article-title":"Aortic Stiffness in a Mortality Risk Calculator for Kidney Transplant Recipients","volume":"99","author":"Dahle","year":"2015","journal-title":"Transplantation"},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1159\/000507824","article-title":"Endostatin Is an Independent Risk Factor of Graft Loss after Kidney Transplant","volume":"51","author":"Chu","year":"2020","journal-title":"Am. J. Nephrol."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"100","DOI":"10.5603\/aa.104293","article-title":"Physical Activity in the Prevention and Treatment of Atherosclerotic Cardiovascular Diseases","volume":"31","author":"Pomianowski","year":"2025","journal-title":"Acta Angiol."},{"key":"ref_83","doi-asserted-by":"crossref","unstructured":"Chukwu, C.A., Rao, A., Middleton, R., and Kalra, P.A. (2024). Post-Transplant Cardiovascular Disease in Kidney Transplant Recipients: Incidence, Risk Factors, and Outcomes in the Era of Modern Immunosuppression. J. Clin. Med., 13.","DOI":"10.3390\/jcm13102734"},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"355","DOI":"10.2215\/CJN.0000000000000360","article-title":"Trends and Specific Causes of Cardiovascular Mortality after Kidney Transplantation in Finland","volume":"19","author":"Helve","year":"2024","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"2473","DOI":"10.1007\/s00253-020-11069-x","article-title":"Gut Microbiota Alterations Associated with Antibody-Mediated Rejection after Kidney Transplantation","volume":"105","author":"Wang","year":"2021","journal-title":"Appl. Microbiol. Biotechnol."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"e1582","DOI":"10.1097\/TXD.0000000000001582","article-title":"Distinct Changes in Gut Microbiota of Patients with Kidney Graft Rejection","volume":"10","author":"Visconti","year":"2024","journal-title":"Transplant. Direct"},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"207","DOI":"10.2147\/TCRM.S401414","article-title":"Shifts in Intestinal Metabolic Profile Among Kidney Transplantation Recipients with Antibody-Mediated Rejection","volume":"19","author":"Wang","year":"2023","journal-title":"Ther. Clin. Risk Manag."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"18881","DOI":"10.1038\/s41598-020-76072-8","article-title":"Effect of the Similarity of Gut Microbiota Composition Between Donor and Recipient on Graft Function After Living Donor Kidney Transplantation","volume":"10","author":"Kim","year":"2020","journal-title":"Sci. Rep."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"e13436","DOI":"10.1111\/ctr.13436","article-title":"Urinary Microbiome Associated with Chronic Allograft Dysfunction in Kidney Transplant Recipients","volume":"32","author":"Wu","year":"2018","journal-title":"Clin. Transplant."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"712","DOI":"10.1111\/ajt.14038","article-title":"Changes in Urinary Microbiome Populations Correlate in Kidney Transplants with Interstitial Fibrosis and Tubular Atrophy Documented in Early Surveillance Biopsies","volume":"17","author":"Modena","year":"2017","journal-title":"Am. J. Transplant."},{"key":"ref_91","doi-asserted-by":"crossref","unstructured":"Chu, C., Elitok, S., Zeng, S., Xiong, Y., Hocher, C.F., Hasan, A.A., Kr\u00e4mer, B.K., and Hocher, B. (2021). C-Terminal and Intact FGF23 in Kidney Transplant Recipients and Their Associations with Overall Graft Survival. BMC Nephrol., 22.","DOI":"10.1186\/s12882-021-02329-7"},{"key":"ref_92","doi-asserted-by":"crossref","unstructured":"Flores-Guerrero, J.L., Ost\u00e9, M.C.J., Baraldi, P.B., Connelly, M.A., Garcia, E., Navis, G., Bakker, S.J.L., and Dullaart, R.P.F. (2021). Association of Circulating Trimethylamine N-Oxide and Its Dietary Determinants with the Risk of Kidney Graft Failure: Results of the TransplantLines Cohort Study. Nutrients, 13.","DOI":"10.3390\/nu13010262"},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"1931","DOI":"10.1093\/ndt\/gfaf071","article-title":"Plasma Trimethylamine N-Oxide Concentration and All-Cause Mortality in Kidney Transplant Recipients","volume":"40","author":"Kremer","year":"2025","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_94","doi-asserted-by":"crossref","unstructured":"Korytowska, N., Wycza\u0142kowska-Tomasik, A., P\u0105czek, L., and Giebu\u0142towicz, J. (2021). Evaluation of Salivary Indoxyl Sulfate with Proteinuria for Predicting Graft Deterioration in Kidney Transplant Recipients. Toxins, 13.","DOI":"10.3390\/toxins13080571"},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"115506","DOI":"10.1016\/j.intimp.2025.115506","article-title":"Gut Microbiota and Metabolites Related Intra-Patient Variability of Tacrolimus Pharmacokinetics Predicted Adverse One-Year Outcomes Following Kidney Transplantation","volume":"165","author":"Xiang","year":"2025","journal-title":"Int. Immunopharmacol."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1186\/s40168-023-01578-y","article-title":"Gut Microbiome Modulates Tacrolimus Pharmacokinetics Through the Transcriptional Regulation of ABCB1","volume":"11","author":"Degraeve","year":"2023","journal-title":"Microbiome"},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"1332","DOI":"10.1016\/j.cell.2016.05.041","article-title":"From Dietary Fiber to Host Physiology: Short-Chain Fatty Acids as Key Bacterial Metabolites","volume":"165","author":"Koh","year":"2016","journal-title":"Cell"},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"1191","DOI":"10.1016\/j.kint.2016.06.033","article-title":"Gut Microbiota in Renal Physiology: Focus on Short-Chain Fatty Acids and Their Receptors","volume":"90","author":"Pluznick","year":"2016","journal-title":"Kidney Int."},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1053\/j.jrn.2010.10.021","article-title":"Evidence-based Guidelines for the Nutritional Management of Adult Kidney Transplant Recipients","volume":"21","author":"Chan","year":"2011","journal-title":"J. Ren. Nutr."},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1093\/eurheartj\/ehy799","article-title":"Impact of Chronic Dietary Red Meat, White Meat, or Non-Meat Protein on Trimethylamine N-Oxide Metabolism and Renal Excretion in Healthy Men and Women","volume":"40","author":"Wang","year":"2019","journal-title":"Eur. Heart J."},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1053\/j.jrn.2015.06.004","article-title":"Trimethylamine N-Oxide from Gut Microbiota in Chronic Kidney Disease Patients: Focus on Diet","volume":"25","author":"Moraes","year":"2015","journal-title":"J. Ren. Nutr."},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"1286","DOI":"10.1093\/advances\/nmab010","article-title":"Gut Microbiota-Derived Trimethylamine N-Oxide and Kidney Function: A Systematic Review and Meta-Analysis","volume":"12","author":"Zeng","year":"2021","journal-title":"Adv. Nutr."},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"1764","DOI":"10.1016\/j.ekir.2021.04.009","article-title":"A Narrative Review of Dietary Approaches for Kidney Transplant Patients","volume":"6","author":"Cyrino","year":"2021","journal-title":"Kidney Int. Rep."},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"238","DOI":"10.2215\/CJN.06710619","article-title":"Mediterranean Style Diet and Kidney Function Loss in Kidney Transplant Recipients","volume":"15","author":"Sotomayor","year":"2020","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"e000283","DOI":"10.1136\/bmjdrc-2016-000283","article-title":"Mediterranean Style Diet Is Associated with Low Risk of New-Onset Diabetes After Renal Transplantation","volume":"5","author":"Corpeleijn","year":"2017","journal-title":"BMJ Open Diabetes Res. Care"},{"key":"ref_106","doi-asserted-by":"crossref","unstructured":"G\u00f3rska, M., and Kurnatowska, I. (2022). Nutrition Disturbances and Metabolic Complications in Kidney Transplant Recipients: Etiology, Methods of Assessment and Prevention\u2014A Review. Nutrients, 14.","DOI":"10.3390\/nu14234996"},{"key":"ref_107","doi-asserted-by":"crossref","unstructured":"Nolte Fong, J.V., and Moore, L.W. (2018). Nutrition Trends in Kidney Transplant Recipients: The Importance of Dietary Monitoring and Need for Evidence-Based Recommendations. Front. Med., 5.","DOI":"10.3389\/fmed.2018.00302"},{"key":"ref_108","doi-asserted-by":"crossref","unstructured":"Zeng, S., Yang, Y., Li, S., Hocher, C.-F., Chu, C., Wang, Z., Zheng, Z., Kr\u00e4mer, B.K., and Hocher, B. (2023). 25(OH)D-but not 1,25(OH)2D\u2013Is an independent risk factor predicting graft loss in stable kidney transplant recipients. Front. Med., 10.","DOI":"10.3389\/fmed.2023.1141646"},{"key":"ref_109","first-page":"CD014804","article-title":"Synbiotics, prebiotics and probiotics for solid organ transplant recipients","volume":"9","author":"Cooper","year":"2022","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"586","DOI":"10.1080\/07315724.2017.1334602","article-title":"Effect of a Short-Course Treatment with Synbiotics on Plasma p-Cresol Concentration in Kidney Transplant Recipients","volume":"36","author":"Guida","year":"2017","journal-title":"J. Am. Coll. Nutr."},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"335","DOI":"10.4285\/ctr.25.0017","article-title":"Impact of Probiotic Supplementation on Kidney Transplantation Outcomes: A Retrospective Propensity Score Matched Study","volume":"39","author":"Jang","year":"2025","journal-title":"Clin. Transplant. Res."},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1097\/FTD.0000000000000640","article-title":"Therapeutic Drug Monitoring of Tacrolimus\u2014Personalized Therapy: Second Consensus Report","volume":"41","author":"Brunet","year":"2019","journal-title":"Ther. Drug Monit."},{"key":"ref_113","doi-asserted-by":"crossref","first-page":"1895","DOI":"10.1097\/TP.0000000000004926","article-title":"Pharmacomicrobiomics: Immunosuppressive Drugs and Microbiome Interactions in Transplantation","volume":"108","author":"Mohamed","year":"2024","journal-title":"Transplantation"},{"key":"ref_114","doi-asserted-by":"crossref","unstructured":"Nguyen, T.V.A., Nguyen, H.D., Nguyen, T.L.H., Le, V.T., Nguyen, X.K., Tran, V.T., Le, D.T., and Ta, B.T. (2023). Higher Tacrolimus Trough Levels and Time in the Therapeutic Range Are Associated with the Risk of Acute Rejection in the First Month After Renal Transplantation. BMC Nephrol., 24.","DOI":"10.1186\/s12882-023-03188-0"},{"key":"ref_115","doi-asserted-by":"crossref","unstructured":"Arteaga-Muller, G.Y., Flores-Trevi\u00f1o, S., Bocanegra-Ibarias, P., Robles-Espino, D., Garza-Gonz\u00e1lez, E., Fabela-Valdez, G.C., and Camacho-Ortiz, A. (2024). Changes in the Progression of Chronic Kidney Disease in Patients Undergoing Fecal Microbiota Transplantation. Nutrients, 16.","DOI":"10.3390\/nu16081109"},{"key":"ref_116","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1111\/ajt.15058","article-title":"Fecal microbiota transplantation for the treatment of recurrent and severe Clostridium difficile infection in solid organ transplant recipients: A multicenter experience","volume":"19","author":"Cheng","year":"2019","journal-title":"Am. J. Transpl."},{"key":"ref_117","doi-asserted-by":"crossref","first-page":"103302","DOI":"10.1016\/j.eclinm.2025.103302","article-title":"Clinical Management of Clostridioides difficile Infection with Faecal Microbiota Transplantation: A Real-World Cohort Study","volume":"85","author":"Paaske","year":"2025","journal-title":"eClinicalMedicine"},{"key":"ref_118","unstructured":"U.S. Food and Drug Administration (2026, May 06). FDA Approves First Orally Administered Fecal Microbiota Product for the Prevention of Recurrence of Clostridioides difficile Infection, Available online: https:\/\/www.fda.gov\/news-events\/press-announcements\/fda-approves-first-orally-administered-fecal-microbiota-product-prevention-recurrence-clostridioides."},{"key":"ref_119","unstructured":"U.S. Food and Drug Administration (2026, May 06). Fecal Microbiota for Transplantation: Safety Communication\u2014Risk of Serious Adverse Reactions Due to Transmission of Multi-Drug Resistant Organisms, Available online: https:\/\/www.fda.gov\/safety\/medical-product-safety-information\/fecal-microbiota-transplantation-safety-communication-risk-serious-adverse-reactions-due."},{"key":"ref_120","doi-asserted-by":"crossref","first-page":"e00161-21","DOI":"10.1128\/JCM.00161-21","article-title":"Fecal Microbiota Transplantation Donor Screening Updates and Research Gaps for Solid Organ Transplant Recipients","volume":"60","author":"Mehta","year":"2022","journal-title":"J. Clin. Microbiol."},{"key":"ref_121","doi-asserted-by":"crossref","first-page":"2228419","DOI":"10.1080\/0886022X.2023.2228419","article-title":"The Gut Microbiome and Metabolome in Kidney Transplant Recipients with Normal and Moderately Decreased Kidney Function","volume":"45","author":"Lan","year":"2023","journal-title":"Ren. Fail."},{"key":"ref_122","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1186\/s12967-025-07465-4","article-title":"Longitudinal Profiling of Gut Microbiota Dynamics in Kidney Transplant Recipients","volume":"24","author":"Zhong","year":"2025","journal-title":"J. Transl. Med."},{"key":"ref_123","doi-asserted-by":"crossref","unstructured":"Kouidhi, S., Zidi, O., Alhujaily, M., Souai, N., Mosbah, A., Belali, T.M., Ghedira, K., El Kossai, I., El Manaa, J., and Mnif, W. (2021). Fecal Metabolomics Reveals Distinct Profiles of Kidney Transplant Recipients and Healthy Controls. Diagnostics, 11.","DOI":"10.3390\/diagnostics11050807"},{"key":"ref_124","doi-asserted-by":"crossref","unstructured":"Medina, C.K., and Aykut, B. (2024). Gut Microbial Dysbiosis and Implications in Solid Organ Transplantation. Biomedicines, 12.","DOI":"10.3390\/biomedicines12122792"},{"key":"ref_125","first-page":"e044260010","article-title":"Differential Diagnosis of Pneumonia, Including COVID-19-Related Pneumonia, Based on Chest X-Rays Using Neural Networks","volume":"11","author":"Semerjak","year":"2026","journal-title":"Med. Res. J."},{"key":"ref_126","doi-asserted-by":"crossref","unstructured":"Vivek, K., and Papalois, V. (2025). AI and Machine Learning in Transplantation. Transplantology, 6.","DOI":"10.3390\/transplantology6030023"},{"key":"ref_127","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1007\/s12272-025-01549-x","article-title":"Associations Between the Gut Microbiota and the Metabolism Rate of Tacrolimus in Kidney Transplant Recipients During the Early Posttransplant Period","volume":"48","author":"Dukaew","year":"2025","journal-title":"Arch. Pharm. Res."},{"key":"ref_128","doi-asserted-by":"crossref","unstructured":"Bian, J., Liebert, A., Bicknell, B., Chen, X.M., Huang, C., and Pollock, C.A. (2022). Faecal Microbiota Transplantation and Chronic Kidney Disease. Nutrients, 14.","DOI":"10.3390\/nu14122528"},{"key":"ref_129","doi-asserted-by":"crossref","first-page":"636","DOI":"10.1177\/10998004241256031","article-title":"The Gut Microbiome and Symptom Burden After Kidney Transplantation: An Overview and Research Opportunities","volume":"26","author":"Lockwood","year":"2024","journal-title":"Biol. Res. Nurs."},{"key":"ref_130","doi-asserted-by":"crossref","first-page":"368","DOI":"10.1177\/10998004241227560","article-title":"Associations Between Gut Microbial Features and Sickness Symptoms in Kidney Transplant Recipients","volume":"26","author":"Sung","year":"2024","journal-title":"Biol. Res. Nurs."},{"key":"ref_131","doi-asserted-by":"crossref","unstructured":"Lecronier, M., Tashk, P., Tamzali, Y., Tenaillon, O., Denamur, E., Barrou, B., Aron-Wisnewsky, J., and Tourret, J. (2020). Gut Microbiota Composition Alterations Are Associated with the Onset of Diabetes in Kidney Transplant Recipients. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0227373"},{"key":"ref_132","doi-asserted-by":"crossref","unstructured":"Blady, K., Pomianowski, B., Sm\u00f3\u0142ka, L., Struga\u0142a, M., Kursa, K., and Stanek, A. (2026). The Therapeutic Potential of Polyphenols in Modulating Barrier Lipids, Microbiome Interactions, and Inflammatory Pathways in Atopic Dermatitis. Nutrients, 18.","DOI":"10.3390\/nu18091365"},{"key":"ref_133","doi-asserted-by":"crossref","unstructured":"Mafra, D., Kemp, J.A., Borges, N.A., Wong, M., and Stenvinkel, P. (2023). Gut Microbiota Interventions to Retain Residual Kidney Function. Toxins, 15.","DOI":"10.3390\/toxins15080499"},{"key":"ref_134","doi-asserted-by":"crossref","unstructured":"Bautista, J., Echeverr\u00eda, C.E., Maldonado-Noboa, I., Ojeda-Mosquera, S., Hidalgo-Tinoco, C., and L\u00f3pez-Cort\u00e9s, A. (2025). The Human Microbiome in Clinical Translation: From Bench to Bedside. Front. Microbiol., 16.","DOI":"10.3389\/fmicb.2025.1632435"}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/18\/13\/2056\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T01:15:41Z","timestamp":1782350141000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/18\/13\/2056"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,24]]},"references-count":134,"journal-issue":{"issue":"13","published-online":{"date-parts":[[2026,7]]}},"alternative-id":["nu18132056"],"URL":"https:\/\/doi.org\/10.3390\/nu18132056","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,24]]}}}