fecal transplantation

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Indications

* little evidence on efficacy for patients with refractory C difficile colitis or a first episode[7]

* effective for patients after a first or second episode of C difficile colitis[19]

* recommended only second recurrence (third episode) of C difficile colitis[20]

Contraindications

Clinical significance

* overall efficacy is 85%, but evidence is weak[7]

Specimen

Procedure

* non-toxigenic C difficile strains lack the genes for toxin production &, thus, may colonize the gut without causing colitis[8]

Complications

Notes

More general terms

Additional terms

References

  1. Mattila E et al. Fecal transplantation, through colonoscopy, is effective therapy for recurrent Clostridium difficile infection. Gastroenterology 2012 Mar; 142:490. PMID: https://www.ncbi.nlm.nih.gov/pubmed/22155369
  2. 2.0 2.1 2.2 2.3 2.4 Brandt LJ et al. Long-term follow-up of colonoscopic fecal microbiota transplant for recurrent Clostridium difficile infection. Am J Gastroenterol 2012 Jul; 107:1079. PMID: https://www.ncbi.nlm.nih.gov/pubmed/22450732
  3. 3.0 3.1 3.2 3.3 van Nood E et al Duodenal Infusion of Donor Feces for Recurrent Clostridium difficile. New Engl J Med. January 16, 2013 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/23323867 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMoa1205037
    Kelly CP Fecal Microbiota Transplantation - An Old Therapy Comes of Age. New Engl J Med. January 16, 2013 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/23323865 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMe1214816
  4. 4.0 4.1 Konijeti GG et al. Cost-effectiveness of competing strategies for management of recurrent Clostridium difficile infection: A decision analysis. Clin Infect Dis 2014 Mar 31; PMID: https://www.ncbi.nlm.nih.gov/pubmed/24692533
    Youngster I et al. Fecal microbiota transplant for relapsing Clostridium difficile infection using a frozen inoculum from unrelated donors: A randomized, open-label, controlled pilot study. Clin Infect Dis 2014 Apr 23; PMID: https://www.ncbi.nlm.nih.gov/pubmed/24762631
  5. Burke KE, Lamont JT. Fecal transplantation for recurrent Clostridium difficile infection in older adults: a review. J Am Geriatr Soc. 2013;61:1394-1398. PMID: https://www.ncbi.nlm.nih.gov/pubmed/23869970
  6. Kelly CR et al. Fecal microbiota transplant for treatment of Clostridium difficile infection in immunocompromised patients. Am J Gastroenterol 2014 Jul; 109:1065 PMID: https://www.ncbi.nlm.nih.gov/pubmed/24890442
  7. 7.0 7.1 7.2 Drekonja D et al Fecal Microbiota Transplantation for Clostridium difficile Infection: A Systematic Review Ann Intern Med. 2015;162(9):630-638 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25938992 <Internet> http://annals.org/article.aspx?articleid=2288521
  8. 8.0 8.1 8.2 Gerding DN et al Administration of Spores of Nontoxigenic Clostridium difficile Strain M3 for Prevention of Recurrent C difficile Infection. A Randomized Clinical Trial. JAMA. 2015;313(17):1719-1727 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25942722 <Internet> http://jama.jamanetwork.com/article.aspx?articleid=2281703
  9. 9.0 9.1 9.2 Moayyedi P et al. Fecal microbiota transplantation induces remission in patients with active ulcerative colitis in a randomized controlled trial. Gastroenterology 2015 Jul; 149:102 PMID: https://www.ncbi.nlm.nih.gov/pubmed/25857665
  10. 10.0 10.1 10.2 Lee CH, Steiner T, Petrof EO et al Frozen vs Fresh Fecal Microbiota Transplantation and Clinical Resolution of Diarrhea in Patients With Recurrent Clostridium difficile Infection. A Randomized Clinical Trial. JAMA. 2016;315(2):142-149. http://jama.jamanetwork.com/article.aspx?articleid=2481003
  11. 11.0 11.1 Kelly CR, Khoruts A, Staley C et al Effect of Fecal Microbiota Transplantation on Recurrence in Multiply Recurrent Clostridium difficile Infection: A Randomized Trial. Ann Intern Med. Published online 23 August 2016 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/27547925 <Internet> http://annals.org/article.aspx?articleid=2545886
    Hohmann EL Are Microbial Politics Local? <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/27548329 <Internet> http://annals.org/article.aspx?articleid=2545957
  12. 12.0 12.1 Johnsen PH, Hilpusch F, Cavanagh JP et al Faecal microbiota transplantation versus placebo for moderate- to-severe irritable bowel syndrome: a double-blind, randomised, placebo-controlled, parallel-group, single-centre trial. Lancet Gastroenterology and Hepatology Oct 31, 2017 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/29100842 <Internet> http://thelancet.com/journals/langas/article/PIIS2468-1253(17)30338-2/fulltext
    Ford AC Stool as a treatment for IBS: more questions than answers? Lancet Gastroenterology and Hepatology Oct 31, 2017 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/29100844 <Internet> http://thelancet.com/journals/langas/article/PIIS2468-1253(17)30337-0/fulltext
  13. 13.0 13.1 Kao D, Roach B, Silva M et al Effect of Oral Capsule- vs Colonoscopy-Delivered Fecal Microbiota Transplantation on Recurrent Clostridium difficile Infection. A Randomized Clinical Trial. JAMA. 2017;318(20):1985-1993 PMID: https://www.ncbi.nlm.nih.gov/pubmed/29183074 https://jamanetwork.com/journals/jama/article-abstract/2664458
    Rao K, MD, Young VB, MD, Malani PN. Capsules for Fecal Microbiota Transplantation in Recurrent Clostridium difficile Infection.The New Way Forward or a Tough Pill to Swallow? JAMA. 2017;318(20):1979-1980 PMID: https://www.ncbi.nlm.nih.gov/pubmed/29183052 https://jamanetwork.com/journals/jama/article-abstract/2664435
  14. FDA Safety Alert. June 13, 2019 Fecal Microbiota for Transplantation: Safety Communication- Risk of Serious Adverse Reactions Due to Transmission of Multi- Drug Resistant Organisms. https://www.fda.gov/safety/medwatch-safety-alerts-human-medical-products/fecal-microbiota-transplantation-safety-communication-risk-serious-adverse-reactions-due
    FDA SafetyCommunication. June 13, 2019 Important Safety Alert Regarding Use of Fecal Microbiota for Transplantation and Risk of Serious Adverse Reactions Due to Transmission of Multi-Drug Resistant Organisms. https://www.fda.gov/vaccines-blood-biologics/safety-availability-biologics/important-safety-alert-regarding-use-fecal-microbiota-transplantation-and-risk-serious-adverse
  15. 15.0 15.1 DeFilipp Z, Bloom PP, Torres Soto M Drug-Resistant E. coli Bacteremia Transmitted by Fecal Microbiota Transplant. N Engl J Med. Oct 30, 2019 PMID: https://www.ncbi.nlm.nih.gov/pubmed/31665575 https://www.nejm.org/doi/full/10.1056/NEJMoa1910437
    Kassam Z, Dubois N, Ramakrishna B et al Donor Screening for Fecal Microbiota Transplantation. N Engl J Med. Oct 30, 2019 PMID: https://www.ncbi.nlm.nih.gov/pubmed/31665572 https://www.nejm.org/doi/full/10.1056/NEJMc1913670
    Blaser MJ Fecal Microbiota Transplantation for Dysbiosis - Predictable Risks. N Engl J Med. Oct 30, 2019 PMID: https://www.ncbi.nlm.nih.gov/pubmed/31665573 https://www.nejm.org/doi/full/10.1056/NEJMe1913807
  16. 16.0 16.1 FDA Safety Alert. March 12, 2020 Fecal Microbiota for Transplantation: Safety Alert - Risk of Serious Adverse Events Likely Due to Transmission of Pathogenic Organisms. https://www.fda.gov/safety/medical-product-safety-information/fecal-microbiota-transplantation-safety-alert-risk-serious-adverse-events-likely-due-transmission
  17. 17.0 17.1 Kelly CR, Yen EF, Grinspan AM et al Fecal Microbiota Transplant is Highly Effective in Real-World Practice: Initial Results from the FMT National Registry. Gastroenterology, Oct 1, 2020 PMID: https://www.ncbi.nlm.nih.gov/pubmed/33011173 https://www.gastrojournal.org/article/S0016-5085(20)35221-5/fulltext
  18. FDA Safety Alert. August 22, 2022 Safety Alert Regarding Use of Fecal Microbiota for Transplantation and Additional Safety Protections Pertaining to Monkeypox Virus. https://www.fda.gov/vaccines-blood-biologics/safety-availability-biologics/safety-alert-regarding-use-fecal-microbiota-transplantation-and-additional-safety-protections-0
  19. 19.0 19.1 Baunwall SMD et al. Faecal microbiota transplantation for first or second Clostridioides difficile infection (EarlyFMT): A randomised, double-blind, placebo-controlled trial. Lancet Gastroenterol Hepatol 2022 Dec; 7:1083. PMID: https://www.ncbi.nlm.nih.gov/pubmed/36152636 https://www.thelancet.com/journals/langas/article/PIIS2468-1253(22)00276-X/fulltext
    Allegretti JR. Should faecal microbiota transplantation be used earlier in the treatment framework? Lancet Gastroenterol Hepatol 2022 Dec; 7:1062. PMID: https://www.ncbi.nlm.nih.gov/pubmed/36152634 https://www.thelancet.com/journals/langas/article/PIIS2468-1253(22)00301-6/fulltext
  20. 20.0 20.1 20.2 20.3 20.4 20.5 20.6 20.7 Peery AF et al. AGA clinical practice guideline on fecal microbiota-based therapies for select gastrointestinal diseases. Gastroenterology 2024 Mar; 166:409. PMID: https://www.ncbi.nlm.nih.gov/pubmed/38395525 https://www.gastrojournal.org/article/S0016-5085(24)00041-6/fulltext
  21. OpenBiome: Clinician FAQs http://www.openbiome.org/clinical-faqs/

Patient information

fecal transplantation patient information