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Gut. 2017 Apr;66(4):569-580. doi: 10.1136/gutjnl-2016-313017. Epub 2017 Jan 13.

European consensus conference on faecal microbiota transplantation in clinical practice.

Author information

1
Department of Gastroenterological Area, "A. Gemelli" Hospital, Catholic University of the Sacred Heart, Rome, Italy.
2
Department of Internal Medicine I, Gastroenterology, Endocrinology & Metabolism, Medical University, Innsbruck, Austria.
3
Faculty of Technology and Metallurgy, Department of Biochemical Engineering and Biotechnology, University of Belgrade, Belgrade, Serbia.
4
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Medical University, Graz, Austria.
5
Faculty of Medicine, Immunobiology Research Program, Department of Bacteriology and Immunology, University of Helsinki, Helsinki, Finland.
6
Gastroenterology and Nutrition Department, AP-HP, French Group of Faecal Microbiota Transplantation (GFTF), Saint-Antoine Hospital and UPMC Paris 06, Paris, France.
7
Department of Clinic of Gastroenterology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
8
Tissues and Cells Area, Italian National Transplant Center (CNT), Rome, Italy.
9
Department of Gastroenterology, St. Mark's Hospital, London, UK.
10
Department of Pediatrics, Pediatric Gastroenterology and Liver Unit, Sapienza University, Rome, Italy.
11
Laboratory of Microbiology, "A. Gemelli" Hospital, Catholic University of the Sacred Heart, Rome, Italy.
12
Department of Molecular and Clinical Medicine, Wallenberg Laboratory, University of Gothenburg, Institute of Medicine, Sahlgrenska Academy, Gothenburg, Sweden.
13
Gastroenterology and Hepatology Service, Ramón y Cajal University Hospital, Madrid, Spain.
14
Department of Gastroenterology, Hepatology and Infectious Diseases, Otto-von-Guericke University Hospital, Magdeburg, Germany.
15
Department of Internal Medicine, Academic University Medical Center, Amsterdam, The Netherlands.
16
Laboratory of Microbiology, Wageningen University, Wageningen, The Netherlands.
17
Department of Infectious Diseases, Helsinki University Central Hospital, Helsinki, Finland.
18
Clinic for Gastroenterology and Hepatology, University of Belgrade and School of Medicine, Clinical Center of Serbia, Belgrade, Serbia.
19
Department of Internal Medicine, VU University Medical Center, Amsterdam, The Netherlands.
20
Department of Internal Medicine and Clinical Nutrition, University of Gothenburg, Sahlgrenska Academy, Gothenburg, Sweden.

Abstract

Faecal microbiota transplantation (FMT) is an important therapeutic option for Clostridium difficile infection. Promising findings suggest that FMT may play a role also in the management of other disorders associated with the alteration of gut microbiota. Although the health community is assessing FMT with renewed interest and patients are becoming more aware, there are technical and logistical issues in establishing such a non-standardised treatment into the clinical practice with safety and proper governance. In view of this, an evidence-based recommendation is needed to drive the practical implementation of FMT. In this European Consensus Conference, 28 experts from 10 countries collaborated, in separate working groups and through an evidence-based process, to provide statements on the following key issues: FMT indications; donor selection; preparation of faecal material; clinical management and faecal delivery and basic requirements for implementing an FMT centre. Statements developed by each working group were evaluated and voted by all members, first through an electronic Delphi process, and then in a plenary consensus conference. The recommendations were released according to best available evidence, in order to act as guidance for physicians who plan to implement FMT, aiming at supporting the broad availability of the procedure, discussing other issues relevant to FMT and promoting future clinical research in the area of gut microbiota manipulation. This consensus report strongly recommends the implementation of FMT centres for the treatment of C. difficile infection as well as traces the guidelines of technicality, regulatory, administrative and laboratory requirements.

KEYWORDS:

CLINICAL DECISION MAKING; DIARRHOEAL DISEASE; ENTERIC BACTERIAL MICROFLORA

PMID:
28087657
PMCID:
PMC5529972
DOI:
10.1136/gutjnl-2016-313017
[Indexed for MEDLINE]
Free PMC Article

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