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. 2021 Nov 27;20(1):216.
doi: 10.1186/s12934-021-01705-0.

A comprehensive approach to stool donor screening for faecal microbiota transplantation in China

Jianquan He #  1 , Xingxiang He #  2 , Yonghui Ma #  1 , Luxi Yang #  1 , Haiming Fang  3 , Shu Shang  4 , Huping Xia  5 , Guanghui Lian  6 , Hailing Tang  7 , Qizhi Wang  8 , Junping Wang  9 , Zhihui Lin  10 , Jianbo Wen  11 , Yuedong Liu  12 , Chunbao Zhai  13 , Wen Wang  14 , Xueliang Jiang  15 , Ji Xuan  16 , Morong Liu  17 , Shiyun Lu  10 , Xuejun Li  18 , Han Wang  19 , Cong Ouyang  19 , Man Cao  19 , Aiqiang Lin  19 , Bangzhou Zhang  1 , Depei Wu  20 , Ye Chen  21 , Chuanxing Xiao  22
Affiliations

A comprehensive approach to stool donor screening for faecal microbiota transplantation in China

Jianquan He et al. Microb Cell Fact. .

Abstract

Background: Faecal microbiota transplantation (FMT) is an effective therapy for recurrent Clostridium difficile infections and chronic gastrointestional infections. However, the risks of FMT and the selection process of suitable donors remain insufficiently characterized. The eligibility rate for screening, underlying microbial basis, and core ethical issues of stool donors for FMT are yet to be elucidated in China.

Results: The potential stool donors were screened from December 2017 to December 2019 with the help of an online survey, clinical assessments, and stool and blood testing. Bioinformatics analyses were performed, and the composition and stability of gut microbiota in stool obtained from eligible donors were dynamically observed using metagenomics. Meanwhile, we build a donor microbial evaluation index (DoMEI) for stool donor screening. In the screening process, we also focused on ethical principles and requirements. Of the 2071 participants, 66 donors were selected via the screening process (3.19% success rate). Although there were significant differences in gut microbiota among donors, we found that the changes in the gut microbiota of the same donor were typically more stable than those between donors over time.

Conclusions: DoMEI provides a potential reference index for regular stool donor re-evaluation. In this retrospective study, we summarised the donor recruitment and screening procedure ensuring the safety and tolerability for FMT in China. Based on the latest advances in this field, we carried out rigorous recommendation and method which can assist stool bank and clinicians to screen eligible stool donor for FMT.

Keywords: Donor selection; Ethical issue; Faecal microbiota transplantation; Metagenomics; Microbiota evaluation.

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Conflict of interest statement

Authors Han Wang, Cong Ouyang, Man Cao and Aiqiang Lin were employed by the company Xiamen Treatgut Biotechnology Co., Ltd (Xiamen, China). The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Fig. 1
Fig. 1
Flow program and outcomes of donor screening
Fig. 2
Fig. 2
Shotgun metagenomics evaluation of donor microbiota. A DoMEI scores of candidate donors, based on 13 harmful bacteria, 16 beneficial bacteria, and microbial richness. DoMEI scores less than 10 is set as one of the signs of re-evaluated stool donors. B Relative abundances of pathogens of candidate donors. C Microbial richness (Chao 1, red) and relative abundances of beneficial taxa specific to IBD (blue) in qualified donors
Fig. 3
Fig. 3
Donor gut bacterial variation and stability over time, based on 132 fecal samples consecutively collected from 16 frequent donors. A Differences in gut bacterial alpha-diversity indexes among donors: richness (p < 0.001), evenness (p < 0.001), Shannon (p < 0.001). B Non-metric multidimensional scaling (NMDS) ordinations of gut bacterial communities, based on Bray–Curtis dissimilarity (Stress = 0.17). C Changes in Bray–Curtis dissimilarity of gut microbiota within the same donor over time. Bray–Curtis dissimilarity between consecutive samples was plotted through time
See this image and copyright information in PMC

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