Perioperative skin Staphylococcus dynamics and their association with pruritus in end-stage liver disease patients undergoing liver transplantation
10.7659/j.issn.1005-6947.250177
- VernacularTitle:肝移植围手术期皮肤葡萄球菌属变化与终末期肝病患者瘙痒症状的相关性研究
- Author:
Tianyin WANG
1
;
Yi ZHU
;
Peiting LI
;
Xuyu XIANG
;
Yingzi MING
Author Information
1. 中南大学湘雅三医院 器官移植中心,湖南 长沙 410013;中南大学湘雅三医院 国家卫生健康委员会移植医学转化研究重点实验室,湖南 长沙 410013;湖南省传染病临床研究中心,湖南 长沙 410013
- Publication Type:Journal Article
- Keywords:
Liver Transplantation;
End-Stage Liver Disease;
Pruritus;
Skin;
Staphylococcus
- From:
Chinese Journal of General Surgery
2025;34(5):996-1011
- CountryChina
- Language:Chinese
-
Abstract:
Background and Aims:Patients with end-stage liver disease(ESLD)frequently experience persistent pruritus,which significantly impairs their quality of life.Although relief of pruritus after liver transplantation is often attributed to the normalization of bilirubin levels,the role of skin microbiota in developing pruritus remains unclear.This study aimed to investigate the dynamic changes in skin microbiota during the perioperative period of liver transplantation in ESLD patients and to explore their association with pruritic symptoms.Methods:Fifteen ESLD patients treated in the Third Xiangya Hospital between 2022 and 2023 were enrolled and skin swabs were collected from the anterior tibial region at three time points:before liver transplantation and on postoperative days 7 and 30.Skin samples from 15 age-matched healthy controls were collected at the same anatomical site.Microbial composition was analyzed using 16S rRNA sequencing.Meanwhile,pruritus severity was assessed using a visual analogue scale(VAS),and multiple serological indicators were measured to evaluate correlations between microbiota changes,pruritus severity,and liver function parameters.Results:Compared with healthy controls,ESLD patients exhibited significantly altered β-diversity in skin microbiota and an increased relative abundance of Staphylococcus(LDA>4),which was strongly correlated with VAS scores for pruritus(r=0.93,Padj=3.08×10?1?).On postoperative day 7,α-diversity decreased,and Staphylococcus abundance peaked,then gradually normalized by day 30 as pruritus improved.Further analysis revealed that Staphylococcus abundance was positively correlated with alanine aminotransferase,aspartate aminotransferase,total bilirubin,direct bilirubin,total bile acids,and international normalized ratio,and negatively correlated with albumin(all Padj<0.05).Notably,Staphylococcus levels were significantly higher in patients with moderate to severe pruritus(VAS score>5).Conclusion:ESLD patients demonstrate marked dysbiosis of the skin microbiota during the perioperative period of liver transplantation,characterized by an abnormal proliferation of Staphylococcus,which may contribute to the development and exacerbation of pruritus.Targeting the skin microbiome,particularly interventions against Staphylococcus,may offer a novel therapeutic strategy for alleviating pruritus in ESLD patients.
