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Scaling Safe Access to Fecal Microbiota Transplantation: Past, Present, and Future

  • Pediatric Gastroenterology (S Orenstein, Section Editor)
  • Published:
Current Gastroenterology Reports Aims and scope Submit manuscript

A Correction to this article was published on 08 June 2018

This article has been updated

Abstract

Purpose of Review

Universal stool banks (USBs) have emerged as a potential model for scaling access to fecal microbiota transplantation (FMT) for Clostridium difficile infection (CDI). In this review, we outline the historical barriers constraining access to FMT, the evidence on methods and outcomes of USBs, and potential future directions for expanding access.

Recent Findings

Key historical barriers to FMT access include regulatory uncertainty, operational complexity of sourcing screened donor material, and logistical challenges of delivering fresh treatment preparations. USBs have demonstrated that FMT can be delivered safely at scale by centralizing donor selection, material processing, and safety monitoring. More evidence is needed to optimize USB methods, including for donor screening, material processing, and novel delivery modalities.

Summary

USBs have catalyzed broad access to FMT in North America and Europe. Future directions include developing evidence regarding oral preparations, harmonizing guidelines, disseminating best practice protocols, establishing long-term safety profiles, and expanding access to geographic areas of unmet need

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Change history

  • 08 June 2018

    In the original version of this article, author Ryan Elliott’s name was misspelled as Ryan Eliott. The correct spelling of the name is Ryan Elliott.

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Acknowledgements

The authors thank Neil and Anna Rasmussen Family Foundation and the Anna Maria and Stephen Kellen Foundation, Carolyn Edelstein (OpenBiome) for assistance in designing Fig. 1.

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Authors and Affiliations

  1. OpenBiome, Somerville, MA, USA

    Pratik Panchal, Shrish Budree, Alex Scheeler, Geraldine Medina, Monica Seng, Wing Fei Wong, Ryan Eliott & Majdi Osman

  2. Harvard University T.H. Chan School of Public Health, Boston, MA, 02115, USA

    Pratik Panchal

  3. University of Cape Town, Rondebosch, Cape Town, 7700, South Africa

    Shrish Budree

  4. Finch Therapeutics Group, Somerville, MA, USA

    Thomas Mitchell & Zain Kassam

  5. Harvard Medical School, Boston, MA, 02115, USA

    Jessica R. Allegretti & Majdi Osman

  6. Brigham and Women’s Hospital, Boston, MA, 02115, USA

    Jessica R. Allegretti

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  1. Pratik Panchal
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Pratik Panchal, Shrish Budree, Wing Fei, Ryan Eliott, and Majdi Osman declare no conflict of interest. Monica Seng and Geraldine Medina are employed by OpenBiome, outside the submitted work. Thomas Mitchell, Zain Kassam, and Jessica Allegretti are employed by Finch Therapeutics Group, outside the submitted work. Alex Scheeler is employed by OpenBiome and Finch Therapeutics Group, outside the submitted work.

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This article is part of the Topical Collection on Pediatric Gastroenterology

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Panchal, P., Budree, S., Scheeler, A. et al. Scaling Safe Access to Fecal Microbiota Transplantation: Past, Present, and Future. Curr Gastroenterol Rep 20, 14 (2018). https://doi.org/10.1007/s11894-018-0619-8

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  • DOI: https://doi.org/10.1007/s11894-018-0619-8

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