International consensus conference on stool banking for faecal microbiota transplantation in clinical practice

Giovanni Cammarota¹, Gianluca Ianiro², Colleen R Kelly³, Benjamin H Mullish⁴, Jessica R Allegretti⁵, Zain Kassam^{6

7}, Lorenza Putignani⁸, Monika Fischer⁹, Josbert J Keller^{10

11}, Samuel Paul Costello¹², Harry Sokol^{13

14

15}, Patrizia Kump¹⁶, Reetta Satokari¹⁷, Stacy A Kahn¹⁸, Dina Kao¹⁹, Perttu Arkkila²⁰, Ed J Kuijper²¹, Maria J Gt Vehreschild²², Cristina Pintus²³, Loris Lopetuso²⁴, Luca Masucci²⁵, Franco Scaldaferri²⁴, E M Terveer^{11

21}, Max Nieuwdorp²⁶, Antonio López-Sanromán²⁷, Juozas Kupcinskas²⁸, Ailsa Hart²⁹, Herbert Tilg³⁰, Antonio Gasbarrini³¹

Affiliations

¹ Internal Medicine and Gastroenterology, Day Hospital of Gastroenterology and Intestinal Microbiota Transplantation, Fondazione Policlinico A Gemelli IRCCS, Catholic University of Medicine, Roma, Italy giovanni.cammarota@unicatt.it.
² Internal Medicine and Gastroenterology, Day Hospital of Gastroenterology and Intestinal Microbiota Transplantation, Fondazione Policlinico A Gemelli IRCCS, Roma, Italy.
³ Division of Gastroenterology, Alpert Medical School of Brown University, Providence, Rhode Island, United States of America.
⁴ Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, United Kingdom.
⁵ Division of Gastroenterology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States of America.
⁶ Microbiome Informatics, Massachusetts Institute of Technology, Cambridge, Massachusetts, United States of America.
⁷ OpenBiome, Somerville, Massachusetts, United States of America.
⁸ Parasitology Unit and Human Microbiome Unit, Bambino Gesù Pediatric Hospital, Roma, Italy.
⁹ Department of Medicine, Indiana University, Indianapolis, Indiana, United States of America.
¹⁰ Department of Gastroenterologyand Hepatology, Haaglanden Medical Center, 2597 AX, The Hague, Netherlands.
¹¹ National Donor Feces Bank, LUMC, Leiden, the Netherlands.
¹² Department of Gastroenterology, The Queen Elizabeth Hospital, University of Adelaide, Woodville, South Australia, Australia.
¹³ Service de Gastroenterologie, Hôpital Saint Antoine, Sorbonne Université, Inserm, Centre de Recherche Saint-Antoine, Paris, France.
¹⁴ French Group of Fecal Microbiota Transplantation, Paris, France.
¹⁵ INRA, UMR1319 Micalis, AgroParisTech, Jouy-en-Josas, France.
¹⁶ Division of Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
¹⁷ Human Microbiome Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
¹⁸ Division of Gastroenterology, Hepatology and Nutrition, Boston Children's Hospital, Boston, Massachusetts, Uunited States of America.
¹⁹ Division of Gastroenterology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.
²⁰ Department of Clinic of Gastroenterology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
²¹ Department of Medical Microbiology, Leiden University Medical Centre, Leiden, the Netherlands.
²² Department I of Internal Medicine; German Centre for Infection Research, Partner site Bonn-Cologne, University Hospital of Cologne, Cologne, Germany.
²³ Tissues and Cells Area, Italian National Transplant Center, Rome, Italy.
²⁴ Internal Medicine and Gastroenterology, Fondazione Policlinico A Gemelli IRCCS, Roma, Italy.
²⁵ Microbiology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Catholic University of Medicine, Roma, Italy.
²⁶ Department of Internal Medicine, Amsterdam University Medical Centers, location AMC and VuMC, Amsterdam, Netherlands.
²⁷ Gastroenterology and Hepatology Department, Hospital Universitario Ramon y Cajal, Madrid, Spain.
²⁸ Department of Gastroenterology, Institute for Digestive Research, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
²⁹ Department of Gastroenterology, St Mark's Hospital, London, United Kingdom.
³⁰ Department of Internal Medicine I, Gastroenterology, Endocrinology & Metabolism, Innsbruck Medical University, Innsbruck, Austria.
³¹ Internal Medicine and Gastroenterology, Fondazione Policlinico A Gemelli IRCCS, Catholic University of Medicine, Roma, Italy.

PMID: 31563878
PMCID: PMC6872442
DOI: 10.1136/gutjnl-2019-319548

Review

International consensus conference on stool banking for faecal microbiota transplantation in clinical practice

Giovanni Cammarota et al. Gut. 2019 Dec.

. 2019 Dec;68(12):2111-2121.

doi: 10.1136/gutjnl-2019-319548. Epub 2019 Sep 28.

Authors

Affiliations

¹ Internal Medicine and Gastroenterology, Day Hospital of Gastroenterology and Intestinal Microbiota Transplantation, Fondazione Policlinico A Gemelli IRCCS, Catholic University of Medicine, Roma, Italy giovanni.cammarota@unicatt.it.
² Internal Medicine and Gastroenterology, Day Hospital of Gastroenterology and Intestinal Microbiota Transplantation, Fondazione Policlinico A Gemelli IRCCS, Roma, Italy.
³ Division of Gastroenterology, Alpert Medical School of Brown University, Providence, Rhode Island, United States of America.
⁴ Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, United Kingdom.
⁵ Division of Gastroenterology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States of America.
⁶ Microbiome Informatics, Massachusetts Institute of Technology, Cambridge, Massachusetts, United States of America.
⁷ OpenBiome, Somerville, Massachusetts, United States of America.
⁸ Parasitology Unit and Human Microbiome Unit, Bambino Gesù Pediatric Hospital, Roma, Italy.
⁹ Department of Medicine, Indiana University, Indianapolis, Indiana, United States of America.
¹⁰ Department of Gastroenterologyand Hepatology, Haaglanden Medical Center, 2597 AX, The Hague, Netherlands.
¹¹ National Donor Feces Bank, LUMC, Leiden, the Netherlands.
¹² Department of Gastroenterology, The Queen Elizabeth Hospital, University of Adelaide, Woodville, South Australia, Australia.
¹³ Service de Gastroenterologie, Hôpital Saint Antoine, Sorbonne Université, Inserm, Centre de Recherche Saint-Antoine, Paris, France.
¹⁴ French Group of Fecal Microbiota Transplantation, Paris, France.
¹⁵ INRA, UMR1319 Micalis, AgroParisTech, Jouy-en-Josas, France.
¹⁶ Division of Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
¹⁷ Human Microbiome Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
¹⁸ Division of Gastroenterology, Hepatology and Nutrition, Boston Children's Hospital, Boston, Massachusetts, Uunited States of America.
¹⁹ Division of Gastroenterology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.
²⁰ Department of Clinic of Gastroenterology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
²¹ Department of Medical Microbiology, Leiden University Medical Centre, Leiden, the Netherlands.
²² Department I of Internal Medicine; German Centre for Infection Research, Partner site Bonn-Cologne, University Hospital of Cologne, Cologne, Germany.
²³ Tissues and Cells Area, Italian National Transplant Center, Rome, Italy.
²⁴ Internal Medicine and Gastroenterology, Fondazione Policlinico A Gemelli IRCCS, Roma, Italy.
²⁵ Microbiology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Catholic University of Medicine, Roma, Italy.
²⁶ Department of Internal Medicine, Amsterdam University Medical Centers, location AMC and VuMC, Amsterdam, Netherlands.
²⁷ Gastroenterology and Hepatology Department, Hospital Universitario Ramon y Cajal, Madrid, Spain.
²⁸ Department of Gastroenterology, Institute for Digestive Research, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
²⁹ Department of Gastroenterology, St Mark's Hospital, London, United Kingdom.
³⁰ Department of Internal Medicine I, Gastroenterology, Endocrinology & Metabolism, Innsbruck Medical University, Innsbruck, Austria.
³¹ Internal Medicine and Gastroenterology, Fondazione Policlinico A Gemelli IRCCS, Catholic University of Medicine, Roma, Italy.

PMID: 31563878
PMCID: PMC6872442
DOI: 10.1136/gutjnl-2019-319548

Abstract

Although faecal microbiota transplantation (FMT) has a well-established role in the treatment of recurrent Clostridioides difficile infection (CDI), its widespread dissemination is limited by several obstacles, including lack of dedicated centres, difficulties with donor recruitment and complexities related to regulation and safety monitoring. Given the considerable burden of CDI on global healthcare systems, FMT should be widely available to most centres.Stool banks may guarantee reliable, timely and equitable access to FMT for patients and a traceable workflow that ensures safety and quality of procedures. In this consensus project, FMT experts from Europe, North America and Australia gathered and released statements on the following issues related to the stool banking: general principles, objectives and organisation of the stool bank; selection and screening of donors; collection, preparation and storage of faeces; services and clients; registries, monitoring of outcomes and ethical issues; and the evolving role of FMT in clinical practice,Consensus on each statement was achieved through a Delphi process and then in a plenary face-to-face meeting. For each key issue, the best available evidence was assessed, with the aim of providing guidance for the development of stool banks in order to promote accessibility to FMT in clinical practice.

Keywords: clostridioides difficile; fecal microbiota transplantation; guideline; microbiota; stool bank.

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Conflict of interest statement

Competing interests: JRA received grants from, and consulted for, Finch Therapeutics and Merck and Co. GC, GI, FS and LM received grants in the field of faecal microbiota transplantation (FMT) from the Italian Ministry of Health. SPC received fees from Shire, Ferring, Microbiotica, Pfizer and Janssen. MF is consultant to Finch Therapeutics Group and DSMB member for Rebiotix. AH has served as consultant, advisory board member or speaker for AbbVie, Atlantic, Bristol-Myers Squibb, Celltrion, Falk, Ferring, Janssen, MSD, Napp Pharmaceuticals, Pfizer, Pharmacosmos, Shire and Takeda; she also serves on the Global Steering Committee for Genentech. ZK is an employee/shareholder at Finch Therapeutics and advisor/consultant at OpenBiome. JK and EJK received research grants from Vedanta Bioscences, Boston, USA. CPK is a clinical site for the PRISM FMT trial conducted by Finch Therapeutics. HS received unrestricted study grants: Danone, Biocodex, Enterome; board membership, consultancy or lecture fees: Carenity, Abbvie, Astellas, Danone, Ferring, Mayoly Spindler, MSD, Novartis, Roche, Tillots, Enterome, Maat, BiomX, Biose, Novartis, Takeda; co-funder of Exeliom Biosciences. All the remaining authors have nothing to declare.

Comment in

Stool banking for fecal microbiota transplantation: ready for prime time?
Saha S, Khanna S. Saha S, et al. Hepatobiliary Surg Nutr. 2021 Jan;10(1):110-112. doi: 10.21037/hbsn-20-371. Hepatobiliary Surg Nutr. 2021. PMID: 33575297 Free PMC article. No abstract available.

References

1. van Nood E, Vrieze A, Nieuwdorp M, et al. Duodenal infusion of donor feces for recurrent Clostridium difficile. N Engl J Med 2013;368:407–15. 10.1056/NEJMoa1205037 - DOI - PubMed
1. Lee CH, Steiner T, Petrof EO, et al. Frozen vs fresh fecal microbiota transplantation and clinical resolution of diarrhea in patients with recurrent Clostridium difficile infection. JAMA 2016;315:142–9. 10.1001/jama.2015.18098 - DOI - PubMed
1. Kelly CR, Khoruts A, Staley C, et al. Effect of fecal microbiota transplantation on recurrence in multiply recurrent Clostridium difficile infection. Ann Intern Med 2016;165:609–16. 10.7326/M16-0271 - DOI - PMC - PubMed
1. Cammarota G, Masucci L, Ianiro G, et al. Randomised clinical trial: faecal microbiota transplantation by colonoscopy vs. vancomycin for the treatment of recurrent Clostridium difficile infection. Aliment Pharmacol Ther 2015;41:835–43. 10.1111/apt.13144 - DOI - PubMed
1. Hvas CL, Dahl Jørgensen SM, Jørgensen SP, et al. Fecal microbiota transplantation is superior to fidaxomicin for treatment of recurrent Clostridium difficile infection. Gastroenterology 2019;156:1324–32. 10.1053/j.gastro.2018.12.019 - DOI - PubMed

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International consensus conference on stool banking for faecal microbiota transplantation in clinical practice

Affiliations

International consensus conference on stool banking for faecal microbiota transplantation in clinical practice

Authors

Affiliations

Abstract

Conflict of interest statement

Comment in

References

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources

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Medical