Fecal Microbiota Transplantation: Current Applications, Effectiveness, and Future Perspectives

Abstract

Fecal microbiota transplantation (FMT) is the infusion of liquid filtrate feces from a healthy donor into the gut of a recipient to cure a specific disease. A fecal suspension can be administered by nasogastric or nasoduodenal tube, colonoscope, enema, or capsule. The high success rate and safety in the short term reported for recurrent Clostridium difficile infection has elevated FMT as an emerging treatment for a wide range of disorders, including Parkinson's disease, fibromyalgia, chronic fatigue syndrome, myoclonus dystopia, multiple sclerosis, obesity, insulin resistance, metabolic syndrome, and autism. There are many unanswered questions regarding FMT, including donor selection and screening, standardized protocols, long-term safety, and regulatory issues. This article reviews the efficacy and safety of FMT used in treating a variety of diseases, methodology, criteria for donor selection and screening, and various concerns regarding FMT.

Keywords: Clostridium difficile infection; Colitis, ulcerative; Crohn disease; Fecal microbiota transplantation; Irritable bowel syndrome.

Fig. 1.

Donor and recipient screening for fecal microbiota transplantation. IBD, inflammatory bowel disease; IBS, irritable bowel syndrome; IgM, immunoglobulin M; FMT, fecal microbiota transplantation; HIV, human immunodeficiency virus.

Fig. 2.

Fecal microbiota transplantation procedures. (A) Donor stool and normal saline (1:3) ground in a blender. (B) Fecal suspension in 50-mL syringes. (C) Infusion using colonoscopy.