First implementation of frozen, capsulized faecal microbiota transplantation for recurrent Clostridium difficile infection into clinical practice in Europe

Tacke, Daniela; Wisplinghoff, Hilmar; Kretzschmar, Alexander; Farowski, Fedja; Köehler, Philipp; Herweg, Jens; Cornely, Oliver A.; Vehreschild, Maria J. G. T.

doi:10.1016/j.cmi.2015.06.027

Cited by 7 publications

(2 citation statements)

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“…Fecal material from donors was collected and processed as followed: instant freezing (<3 hours after defecation) at −80°C up to the day of FMT with final careful thawing at room temperature (Bonn, n = 1) or fresh collection (less than 3 hours after defecation; Bonn, n = 1) of single related donors, respectively, and as cryoconserved capsules manufactured as previously published 43 containing fecal material (all Cologne patients; single unrelated donor—n = 8, multiple unrelated donors—n = 1). …”

Section: Material/methodsmentioning

confidence: 99%

Fecal microbiota transfer for refractory intestinal graft‐versus‐host disease — Experience from two German tertiary centers

Goeser

Sifft

Stein‐Thoeringer

et al. 2021

European J of Haematology

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Rationale Steroid refractory graft‐vs‐host disease (sr‐GvHD) represents a challenging complication after allogeneic hematopoietic cell transplantation (allo‐HCT). Intestinal microbiota (IM) diversity and dysbiosis were identified as influencing factors for the development of acute GvHD. Fecal microbiota transfer (FMT) is hypothesized to restore IM dysbiosis, but there is limited knowledge about the significance of FMT in the treatment of sr‐GvHD. Objectives We studied the effects of FMT on sr‐GvHD in allo‐HCT patients from two German tertiary clinical centers (n = 11 patients; period: March 2017 until July 2019). To assess safety and clinical efficacy, we analyzed clinical data pre‐ and post‐FMT (day ‐14 to +30 relative to FMT). Moreover, IM were analyzed in donor samples and in a subset of patients pre‐ and post‐FMT by 16S rRNA sequencing. Results Post‐FMT, we observed no intervention‐associated, systemic inflammatory responses and only minor side effects (5/11 patients: abdominal pain and transformation of peristalsis—each 3/11 and vomiting—1/11). Stool frequencies and volumes were significantly reduced [pre‐ vs post‐FMT (d14): P < .05, respectively] as well as clear attenuation regarding both grading and staging of sr‐GvHD was present upon FMT. Moreover, IM analyses revealed an increase of alpha diversity as well as a compositional shifts toward the donor post‐FMT. Conclusions In our study, we observed positive effects on sr‐GVHD after FMT without the occurrence of major adverse events. Although these findings are in line with published data on beneficial effects of FMT in sr‐GvHD, further randomized clinical studies are urgently needed to better define the clinical validity including mode of action.

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