Page 16 - Introduction to FMT

FMT Introduction

Processed fecal matter is typically delivered into the gastrointestinal tract of the patient by colonoscopy
or duodenal tube/upper endoscopy (Fig 1B). While delivery route often varies from study to study, no
statistically significant difference in outcome is reported between the delivery methods for the treatment
of CDI [11,34]. This finding remains to be validated for the treatment of other diseases, such as IBD or
obesity. Regardless, it is important to consider the potential risks associated with each potential delivery
route.

The protocol for FMT is widely variable, as summarized in Table 1, and standardization of this technique
should help elucidate FMT’s efficacy.

Table 1

Variability in fecal microbiota transplantation methodology.

Points of variability

Potential methodology Potential implications

Patient preparation

Type/length of antibiotic treatment, duration of colon preparation

State of patient’s gut microbiome could impact susceptiblity to transplant

Donor Patient relative, ‘super donor’, designer cultures?

The identification of ‘super-donors’ hints at the possibility of moving toward the creation of safer, more
standardizable synthetic probiotic communities

Sample preparation

Aerobic vs anaerobic; fresh vs frozen vs lyophilized

A recent clincal trial reported no difference in clincal resolution between using fresh or frozen fecal
sample for transplantation

Administration Duodenal tube, colonoscopy, enema, pill

Maximizing practicality of this technique while maintaing efficacy could impacts its prescription and cost

Delivery site Colon, small intestine Spatial dynamics of the human microbiome remains poorly
characterized, but could results in more targeted therapy

FMT Introduction