Reducing barriers to fecal microbiota transplant (FMT)

It is now conventional wisdom that FMT (a.k.a. “stool transplant”, “transfaunation”) is effective treatment for recurrent C. difficile disease. So why aren’t more being done? Many centers, including ours, have stumbled upon two barriers: the ick factor, and the logistics of patient-identified donor selection and screening. Not everyone can identify a willing donor, and there is no easy way to pay for the expensive set of screening lab tests performed on the donor.

So these two reports, which describe moving from patient-identified to universal volunteer donors, are welcome. One of the reports, out of the University of Minnesota, also examines the use of frozen, banked fecal material. In the absence of progress in replicating the fecal microbiome in culture, I think this is the best way to make FMT more universally available.

Don’t worry, I don’t think we’ll be staging “stool drives” in the future, like we do blood drives now. A single universal donor could provide all the stool required by a single center to treat multiple patients with C. difficile, and could be called back whenever the bank was running low (“Honey, it’s the clinic calling, they need more of your sh**”).

If you don’t have subscription access to the articles above, here is a short summary from the IDSA newsletter.

Image from www.zazzle.com