Donor Considerations in Fecal Microbiota Transplantation
- 933 Downloads
Purpose of Review
Tremendous acceleration has been made in understanding the gut microbiota in the past decade and, with it, further understanding of the pathologic role of dysbiosis and the use of fecal microbiota transplantation (FMT) as therapy. FMT has been studied in many disease states including the most common indication of Clostridium difficile infection (CDI), though many questions regarding stool donor selection remain.
Though traditionally, one donor has provided stool for one patient, research is underway to explore many donor selection considerations from the use of pooled donor stool to selection of a high diversity donor. It is well-known that dietary intake shapes the gut microbiota and the potential implications of this on FMT donor selection are being explored.
Though further high-quality research is needed, optimizing the fecal microbiota inoculum holds great promise.
KeywordsFecal microbiota transplant Clostridium difficile infection FMT donor Competitive donor
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
The views expressed in this article are those of the authors and do not reflect the official policy or position of the Department of the Navy, Department of Defense, or the US Government.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
- 3.Bakken JS et al. Treating Clostridium difficile infection with fecal microbiota transplantation. Clin Gastroenterol Hepatol Off Clin Pract J Am Gastroenterol Assoc. 2011;9:1044–9.Google Scholar
- 5.•• Lee CH 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;315:142–9. This study represents the largest randomized clinical trial of FMT to date.CrossRefPubMedGoogle Scholar
- 16.Moayyedi P, et al. Fecal microbiota transplantation induces remission in patients with active ulcerative colitis in a randomized controlled trial. Gastroenterology. 2015;149, 102–109.e6.Google Scholar
- 17.Vrieze A, et al. Transfer of intestinal microbiota from lean donors increases insulin sensitivity in individuals with metabolic syndrome. Gastroenterology. 2012;143:913–916.e7.Google Scholar
- 18.• Bousvaros A, Wang K, Rustgi A, Vender R, Relman D. Current consensus guidance on donor screening and stool testing for FMT; 2013. This guidance is used as the primary reference for pre-donation screening for potential donors.Google Scholar