Abstract 17908: Changes in Gut Microbiome Early After Fontan Operation

Introduction: A growing body of evidence supports the role of the gut microbiome in human health and well-being. The unique physiological conditions imposed by the Fontan operation (FO) may influence intestinal circulation and oxygen delivery thus altering the gut microbiome. Methods: Stool samples were obtained in children just prior to FO (T1), early postop within 5-7 days after FO (T2), and late postop 3-9 months after FO (T3). At early postop T2 all subjects were taking oral feeds, had at least one well-formed bowel movement and were off all cardiovascular infusions. Shotgun metagenomic sequencing of the microbiota was performed. Community-level differences between time points were assessed by PERMANOVA tests of Bray-Curtis distance between samples. Differentially abundant taxa were identified by generalized linear mixed models. Enteric protein loss was measured by level of stool alpha-1-antitrypsin concentration and its relationship to the gut microbiota was explored. Results: Specimens from 32 subje...