scholarly journals Donor Screening for Fecal Microbiota Transplantation

2020 ◽  
Vol 95 (3) ◽  
pp. 181-187
Author(s):  
Han Hee Lee ◽  
Young-Seok Cho
Keyword(s):  
Randomized Clinical Trials ◽  
Fecal Microbiota Transplantation ◽  
Case Series ◽  
Fecal Microbiota ◽  
Resistant Bacteria ◽  
Screening Process ◽  
Antibiotic Resistant ◽  
Donor Screening ◽  
Large Case Series ◽  
Large Case

Fecal microbiota transplantation (FMT), which has been established as the standard treatment for recurrent <i>Clostroides</i> difficile infection, may also play a role in the management of other diseases associated with dysbiosis of the gut microbiota. To ensure efficacy and safety of FMT, an appropriate donor screening process is required. The main purpose of donor screening is to check for infectious diseases that could be transmitted to the recipient. The screening process involves a medical history questionnaire, and blood and stool testing. Several randomized clinical trials and large case series on FMT reported no, or few, adverse events related to infection by following this donor screening process. However, there is still concern over the transmission of antibiotic-resistant bacteria. In addition, a low donor acceptance rate due to rigorous screening makes donor recruitment difficult, and also imposes a significant cost burden. A consensus on the most crucial elements of donor screening is needed for wide application of FMT.

scholarly journals Beyond fecal microbiota transplantation: Developing drugs from the microbiome

2020 ◽  
Author(s):  
Ylaine Gerardin ◽  
Sonia Timberlake ◽  
Jessica R Allegretti ◽  
Mark B Smith ◽  
Zain Kassam
Keyword(s):  
Public Health ◽  
Drug Discovery ◽  
Infectious Diseases ◽  
Health Outcomes ◽  
Patient Care ◽  
Fecal Microbiota Transplantation ◽  
Fecal Microbiota ◽  
Resistant Bacteria ◽  
Antibiotic Resistant Bacteria ◽  
Antibiotic Resistant

Abstract The transfer of live gut microbes may transform patient care across a range of autoimmune, metabolic, hepatic and infectious diseases. One early approach, fecal microbiota transplantation, has shown promise in Clostridiodes difficile infection and the potential for improving clinical and public health outcomes for other antibiotic-resistant bacteria. These clinical successes have motivated the development of microbiome drugs, which will need to address challenges in safety, uniformity, and delivery while seeking to preserve the benefits of using whole microbiome communities as novel therapeutics and an innovative platform for drug discovery.

Challenges of Screening Prospective Stool Donors for Fecal Microbiota Transplantation

2020 ◽  
Vol 23 (1) ◽  
pp. 21-30
Author(s):  
Nancy E. Dubois ◽  
Catherine Y. Read ◽  
Kelsey O’Brien ◽  
Kelly Ling
Keyword(s):  
Clinical Assessment ◽  
Fecal Microbiota Transplantation ◽  
Fecal Microbiota ◽  
Assessment Process ◽  
Future Research ◽  
Laboratory Assessment ◽  
Screening Process ◽  
Screening Programs ◽  
Donor Screening ◽  
Institutional Adoption

Despite high efficacy rates, significant costs and logistical challenges associated with procuring stool from healthy donors for fecal microbiota transplantation (FMT) have presented barriers to broader institutional adoption and limited the availability of this life-saving treatment. Published outcomes for donor screening programs report donor deferral rates between 90% and 96%. Due to the paucity of FMT donor screening data, a secondary analysis on a cohort of previously screened donors (n = 7,968) was conducted to provide a synopsis of the observed trends and rationales for prospective stool donor deferrals. Upon completion of the evaluation, 1.7% of prospective donors (n = 134) qualified for stool donation. Over 50% of donors who completed the online pre-screen were deferred, primarily for a body mass index of 30 kg/m2 or greater (n = 1,516, 37.0%), logistics (n = 841, 20.5%), and travel history (n = 638, 15.5%). Despite pre-screening, 569 donors (72.8%) who completed the in-person clinical assessment were ultimately deferred due primarily to potentially microbiome-mediated diseases (n = 187, 32.9%). A notably small portion of donors (n = 46, 25.6%) were deferred during the laboratory assessment process suggesting the clinical assessment was effective at deferring donors at higher risk for transmissible diseases. Donors lost to follow-up throughout the screening process presented a significant challenge and contributed to a notable (n = 3,117; 39.1%) portion of donor attrition. Findings were used to support recommendations for improving prospective stool donor screening programs and to provide suggestions for future research.

scholarly journals Ethical Implications of the Fecal Microbiota Transplantation: Disclosure of a False-Positive HIV Test

2021 ◽  
Vol 2021 ◽  
pp. 1-3
Author(s):  
Caitlyn Hollingshead ◽  
Jacob Ciricillo ◽  
Joel Kammeyer
Keyword(s):  
False Positive ◽  
Fecal Microbiota Transplantation ◽  
Therapeutic Option ◽  
Fecal Microbiota ◽  
Screening Process ◽  
Ethical Implications ◽  
Donor Screening ◽  
Clostridioides Difficile ◽  
Hiv Test ◽  
Clostridioides Difficile Infection

Fecal microbiota transplantation (FMT) has gained popularity as an effective therapeutic option for Clostridioides difficile infection (CDI). Since its FDA recognition as a treatment modality for recurrent CDI in 2013, screening protocols for FMT donor stool have been in flux. However, extensive health questionnaires, in combination with serological and stool assays, have become mainstays in the donor screening process, although ethical implications are yet to be thoroughly considered. Herein, we present the case of a family member found to have a false-positive HIV test during the donor screening process and discuss potential ethical ramifications associated with FMT stool donation.

scholarly journals New Developments in Microbiome in Alcohol-Associated and Nonalcoholic Fatty Liver Disease

2021 ◽  
Author(s):  
Phillipp Hartmann ◽  
Bernd Schnabl
Keyword(s):  
Liver Disease ◽  
Fatty Liver ◽  
Nonalcoholic Fatty Liver Disease ◽  
Intestinal Microbiota ◽  
Fatty Liver Disease ◽  
Randomized Clinical Trials ◽  
Fecal Microbiota Transplantation ◽  
Fecal Microbiota ◽  
Intestinal Microbiome ◽  
Nonalcoholic Fatty Liver

AbstractAlcohol-associated liver disease (ALD) and nonalcoholic fatty liver disease (NAFLD) are important causes of morbidity and mortality worldwide. The intestinal microbiota is involved in the development and progression of both ALD and NAFLD. Here we describe associated changes in the intestinal microbiota, and we detail randomized clinical trials in ALD and NAFLD which evaluate treatments modulating the intestinal microbiome including fecal microbiota transplantation, probiotics, prebiotics, synbiotics, and antibiotics. Finally, we discuss precision medicine approaches targeting the intestinal microbiome to ameliorate ALD and NAFLD.

76 FECAL MICROBIOTA TRANSPLANTATION (FMT) FOR THE TREATMENT OF IMMUNE-MEDIATED DIARRHEA AND COLITIS: A CASE SERIES

2021 ◽  
Vol 160 (6) ◽  
pp. S-17
Author(s):  
Arielle Elkrief ◽  
Jonathan U. Peled ◽  
Matthew D. Hellmann ◽  
Jamie E. Chaft ◽  
Juliana Eng ◽  
...  
Keyword(s):  
Fecal Microbiota Transplantation ◽  
Case Series ◽  
Fecal Microbiota ◽  
Immune Mediated
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