Overview of Fecal Microbiota Transplantation (FMT)
Author: Disabled World : Contact: disabled-world.com
Published: 2017-02-20 : (Rev. 2018-05-01)
General information regarding Fecal microbiota transplants (FMT), the taking of feces from a person and and placing it inside the colon of someone else.
Fecal microbiota transplants (FMT) are just what they sound like. They involve taking a person's feces and putting them inside the colon of someone else. The goal of FMT is to treat the condition by restoring a patient's gut microbiota to that more typical of a healthy person.
Fecal microbiota transplantation - (bacteriotherapy, stool transplant) - is defined as the transfer of fecal material containing bacteria and natural antibacterials from a healthy individual into a diseased recipient. Previous terms for the procedure include fecal bacteriotherapy, fecal transfusion, fecal transplant, stool transplant, fecal enema, and human probiotic infusion (HPI). Because the procedure involves the complete restoration of the entire fecal microbiota, not just a single agent or combination of agents, these terms have now been replaced by the new term fecal microbiota transplantation.
In the last few years a number of studies have shown that gut microbiota plays an important role in several human diseases, including irritable bowel syndrome (IBS), Clostridium difficile infection (CDI), Parkinson's disease (PD), and autism spectrum disorder (ASD). Researchers are now hopeful that a procedure known as fecal microbiota transplantation (FMT) and other therapies that target human gut microbiome can be used to treat these diseases in the future.
Fecal microbiota transplant is the process of transplantation of fecal bacteria from a healthy individual into a recipient. FMT involves restoration of the colonic microflora by introducing healthy bacterial flora through infusion of stool, e.g. by enema, orogastric tube, or by mouth, in the form of a capsule containing freeze-dried material, obtained from a healthy donor.
Fecal transplant was first documented in 4th century China, known as "yellow soup". It has been used for over 100 years in veterinary medicine, and has been used regularly for decades in many countries as the first line of defense, or treatment of choice, for C. diff. The prevalence of recurrent or refractory Clostridium difficile infection has been steadily increasing since the year 2000. Consequently, alternative treatments to the standard antibiotic therapies are now being considered.
Researchers are also exploring FMT's potential role for treating other gastrointestinal diseases, such as Irritable Bowel Syndrome (IBS), Ulcerative Colitis, Crohn's Disease, constipation, and neurological conditions such as multiple sclerosis and Parkinson's Disease. More research studies are still needed to determine if fecal transplantation should/could be performed for other clinical indications.
Fecal Microbiota Transplantation Donor Selection
You will need to identify a potential donor prior to your fecal transplantation. Donors should not:
- Be immunocompromised
- Have any history of drug use
- Have any history of incarceration
- Have recently traveled to endemic areas
- Have any history of high-risk sexual behavior
- Have had any antibiotic exposure in the past six months
- Have had any tattooing or body piercing in past six months
- Have any chronic GI disorders, such as inflammatory bowel disease
A potential donor will need to be screened by their physician for infectious pathogens by undergoing the following tests:
- Blood tests: Hepatitis A, B, and C serologies; HIV; RPR.
- Stool tests: Ova and parasites; C. difficile PCR; culture and sensitivity; giardia antigen.
Doctors have reported some cases of sudden weight gain and new bowel disease after fecal transplants. And even people who appear to be in robust health can silently carry germs they can pass to others.
Donors should be informed that their insurance company might hold them financially responsible for all testing required prior to transplant. It is best that they check with their primary care provider and/or insurance company.
In spring of 2013, the FDA announced it was classifying fecal matter as both an Investigational New Drug (IND) and a Biologic, and that only physicians currently in possession of an approved IND application would be allowed to continue performing fecal transplant. This announcement resulted in less than 20 U.S. physicians being allowed to perform fecal transplant. However, on June 17th, 2013, the FDA reversed their position, and announced that qualified physicians could continue to perform FMT for recurrent C. diff. only, with signed consents from patients and tested donor stool.
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