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

Giovanni Cammarota, Gianluca Ianiro, Colleen R Kelly, Benjamin H Mullish, Jessica R Allegretti, Zain Kassam, Lorenza Putignani, Monika Fischer, Josbert J Keller, Samuel Paul Costello, Harry Sokol, Patrizia Kump, Reetta Satokari, Stacy A Kahn, Dina Kao, Perttu Arkkila, Ed J Kuijper, Maria J Gt Vehreschild, Cristina Pintus, Loris Lopetuso, Luca Masucci, Franco Scaldaferri, E M Terveer, Max Nieuwdorp, Antonio López-Sanromán, Juozas Kupcinskas, Ailsa Hart, Herbert Tilg, Antonio Gasbarrini

Journal: Gut 2019;68(12):2111-2121

PMID: 31563878

Free Full Text on HighWire View on PubMed

Abstract

Although faecal microbiota transplantation (FMT) has a well-established role in the treatment of recurrent 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.

Address: Internal Medicine and Gastroenterology, Day Hospital of Gastroenterology and Intestinal Microbiota Transplantation, Fondazione Policlinico A Gemelli IRCCS, Catholic University of Medicine, Roma, Italy [email protected].; Internal Medicine and Gastroenterology, Day Hospital of Gastroenterology and Intestinal Microbiota Transplantation, Fondazione Policlinico A Gemelli IRCCS, Roma, Italy.; Division of Gastroenterology, Alpert Medical School of Brown University, Providence, Rhode Island, United States of America.; Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, United Kingdom.; Division of Gastroenterology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States of America.; Microbiome Informatics, Massachusetts Institute of Technology, Cambridge, Massachusetts, United States of America.; OpenBiome, Somerville, Massachusetts, United States of America.; Parasitology Unit and Human Microbiome Unit, Bambino Gesù Pediatric Hospital, Roma, Italy.; Department of Medicine, Indiana University, Indianapolis, Indiana, United States of America.; Department of Gastroenterologyand Hepatology, Haaglanden Medical Center, 2597 AX, The Hague, Netherlands.; National Donor Feces Bank, LUMC, Leiden, the Netherlands.; Department of Gastroenterology, The Queen Elizabeth Hospital, University of Adelaide, Woodville, South Australia, Australia.; Service de Gastroenterologie, Hôpital Saint Antoine, Sorbonne Université, Inserm, Centre de Recherche Saint-Antoine, Paris, France.; French Group of Fecal Microbiota Transplantation, Paris, France.; INRA, UMR1319 Micalis, AgroParisTech, Jouy-en-Josas, France.; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.; Human Microbiome Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland.; Division of Gastroenterology, Hepatology and Nutrition, Boston Children's Hospital, Boston, Massachusetts, Uunited States of America.; Division of Gastroenterology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.; Department of Clinic of Gastroenterology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.; Department of Medical Microbiology, Leiden University Medical Centre, Leiden, the Netherlands.; Department I of Internal Medicine; German Centre for Infection Research, Partner site Bonn-Cologne, University Hospital of Cologne, Cologne, Germany.; Tissues and Cells Area, Italian National Transplant Center, Rome, Italy.; Internal Medicine and Gastroenterology, Fondazione Policlinico A Gemelli IRCCS, Roma, Italy.; Microbiology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Catholic University of Medicine, Roma, Italy.; National Donor Feces Bank, LUMC, Leiden, the Netherlands.; Department of Medical Microbiology, Leiden University Medical Centre, Leiden, the Netherlands.; Department of Internal Medicine, Amsterdam University Medical Centers, location AMC and VuMC, Amsterdam, Netherlands.; Gastroenterology and Hepatology Department, Hospital Universitario Ramon y Cajal, Madrid, Spain.; Department of Gastroenterology, Institute for Digestive Research, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.; Department of Gastroenterology, St Mark's Hospital, London, United Kingdom.; Department of Internal Medicine I, Gastroenterology, Endocrinology & Metabolism, Innsbruck Medical University, Innsbruck, Austria.; Internal Medicine and Gastroenterology, Fondazione Policlinico A Gemelli IRCCS, Catholic University of Medicine, Roma, Italy.

DOI: 10.1136/gutjnl-2019-319548