28 April 2026 : Review article
Urinary Microbiome Characteristics in Kidney Transplant Recipients and Their Clinical Implications: A Narrative Review
Shuzhan Sun ABCDEF 1,2, Yuhui He ABDEF 1, Yisen Deng ABDEF 1, Jianfeng Wang ACDEFG 1*DOI: 10.12659/AOT.952286
Ann Transplant 2026; 31:e952286
Table 1 Typical urobiome differences between healthy individuals and kidney transplant recipients and potential clinical implications.
| Feature | Healthy individuals (typical) | Kidney transplant recipients (typical) | Clinical implication | Key references |
|---|---|---|---|---|
| -Diversityα | Varies by sex/age/menopausal status | Often reduced post-transplant in several cohorts | Lower diversity may associate with higher risk of infection and adverse graft outcomes | [,,]11 |
| Community stability (longitudinal) | Relatively stable within individuals | More dynamic under antibiotics/immunosuppression | Microbiome shifts may precede clinical events → surveillance opportunity | [,]11 |
| Putatively protective taxa | Lactobacillus commonly enriched in many female cohorts | Depletion of Lactobacillus reported in some post-transplant contexts | Loss of colonization resistance may increase UTI susceptibility | [,]15 |
| Opportunistic taxa | Usually low abundance | Enrichment of Enterococcus/Enterobacteriaceae reported in some cohorts | May reflect antibiotic selection and increased UTI risk | [,,]11 |
| CAD-associated signals | No consistent “CAD taxa” | Corynebacterium enrichment reported in CAD | Potential association with chronic injury (correlative) | []40 |
| α-diversity – within-sample microbial diversity; UTI – urinary tract infection; CAD – chronic allograft dysfunction; EQUC – expanded quantitative urine culture; 16S rRNA – 16S ribosomal RNA. “Typical” patterns summarize trends across heterogeneous cohorts and may differ by sampling method (voided midstream vs catheter vs suprapubic aspiration), peri-transplant timing, antibiotic exposure, immunosuppressive regimen, and sequencing platform. Dominant taxa are shown at genus level unless specified. | ||||