Selecting Donors for Fecal Microbiota Transplantation

Selecting Donors for Fecal Microbiota Transplantation While fecal microbiota transplantation (FMT) is viewed as a relatively inexpensive and safe method for treating recurring Clostridium difficile infection and other maladies in humans, FMT is not without its challenges, particularly with regard to the screening and selection of fecal donors.

In a recent Gut Microbes publication, Woodworth et al. discussed current challenges pertaining to FMT for human use1. The authors evaluate current recommendations for selection and screening of fecal donors as well as additional factors that may impact future donor screening recommendations.

Screening Donors for Fecal Microbiota Transplantation

Mitigating harm to recipients remains the primary driver of current exclusion criteria for donors. Woodworth et al. effectively summarize and present these exclusion criteria within Table 1 of their review1. Included within this table is a list of pathogens that have been screened for using either blood- or stool-based tests.

It is noteworthy that the detection of viruses and parasites are among the most common reasons for donor exclusion based on stool testing2,3.

In addition, FMT donors/materials were screened for the following:

  • Non-bacterial members of the gut microbiota
  • Obesity and metabolic diseases
  • Microbiome diversity
  • Oncogenic potential of donor microbiota
  • Antibiotic resistance
  • Asymptomatic transmissible conditions
Although this review is focused on clinical use of FMT, it can be argued that some of the author's points should also be carefully considered in the design of rodent FMT discovery studies utilizing human stool.

1. Woodworth MH, Carpentieri C, Sitchenko KL, Kraft CS. Challenges in fecal donor selection and screening for fecal microbiota transplantation: A review. Gut Microbes. 2017. Jan 27; 1-13. [Epub ahead of print]. PubMed PMID: 28129018.
2. Burns LJ, Dubois N, Smith MB, Mendolia GM, Burgess J, Edelstein C, Noh A, Alm E, Kassam Z. 499 donor recruitment and eligibility for fecal microbiota transplantion: results from an international public stool bank. Gastroenterology. 2015; 148:S-96-S-97.
3. Paramsothy S, Borody TJ, Lin E, Finlayson S, Walsh AJ, Ng W, et al. Donor recruitment for fecal microbiota transplantion. Inflamm Bowel Dis. 2015; 21:1600-6. PubMed PMID: 26070003.

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