GESA calls for frozen stool banks

Thursday, 17 Sep 2015

Frozen stool banks should be set up across the country so that all patients with recurrent or refractory CDI have access to faecal transplants, GESA has said in a position statement.

This approach offered many benefits over the use of patient-directed donors or ad hoc arrangements, such as avoiding coercion of donors and ethical and confidentiality concerns, the society said in its statement published this week.

Faecal microbiota transplants (FMT) had a favourable short-term risk profile but long term risks were unknown and must be factored into screening protocols and conveyed to patients during consent for the procedure, the statement advised.

Furthermore potential donors with any element of the metabolic syndrome should be excluded as evidence from animal studies showed that an obesogenic phenotype might be transmitted via FMT.

A history of active gastrointestinal illness, malignancy, autoimmune or atopic disease, chronic pain syndromes, neurological or developmental disorders or antibiotic use in the preceding 3 months also should be exclusion criteria.

Whilst FMT’s therapeutic efficacy is proven for rCDI, there is currently insufficient evidence to recommend FMT as a treatment for any other indication, the society noted.

A number of international clinical trials recently reported and currently underway were assessing the therapeutic potential of FMT in a number of gastrointestinal and other diseases.

“The results of these should be awaited prior to any more general adoption of this therapy, given the lack of longer-term safety data and the possibility that FMT may transmit unintended disease,” it said.

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