Details

Autor(en) / Beteiligte

• Cheng, Yao‐Wen
• Phelps, Emmalee
• Ganapini, Vincent
• Khan, Noor
• Ouyang, Fangqian
• Xu, Huiping
• Khanna, Sahil
• Tariq, Raseen
• Friedman‐Moraco, Rachel J.
• Woodworth, Michael H.
• Dhere, Tanvi
• Kraft, Colleen S.
• Kao, Dina
• Smith, Justin
• Le, Lien
• El‐Nachef, Najwa
• Kaur, Nirmal
• Kowsika, Sree
• Ehrlich, Adam
• Smith, Michael
• Safdar, Nasia
• Misch, Elizabeth Ann
• Allegretti, Jessica R.
• Flynn, Ann
• Kassam, Zain
• Sharfuddin, Asif
• Vuppalanchi, Raj
• Fischer, Monika

Titel

Fecal microbiota transplantation for the treatment of recurrent and severe Clostridium difficile infection in solid organ transplant recipients: A multicenter experience

Ist Teil von

• American journal of transplantation, 2019-02, Vol.19 (2), p.501-511

Ort / Verlag

United States: Wiley Subscription Services, Inc

Erscheinungsjahr

2019

Quelle

Wiley-Blackwell Journals

Beschreibungen/Notizen

• Fecal microbiota transplant (FMT) is recommended for Clostridium difficile infection (CDI) treatment; however, use in solid organ transplantation (SOT) patients has theoretical safety concerns. This multicenter, retrospective study evaluated FMT safety, effectiveness, and risk factors for failure in SOT patients. Primary cure and overall cure were defined as resolution of diarrhea or negative C difficile stool test after a single FMT or after subsequent FMT(s) ± anti‐CDI antibiotics, respectively. Ninety‐four SOT patients underwent FMT, 78% for recurrent CDI and 22% for severe or fulminant CDI. FMT‐related adverse events (AE) occurred in 22.3% of cases, mainly comprising self‐limiting conditions including nausea, abdominal pain, and FMT‐related diarrhea. Severe AEs occurred in 3.2% of cases, with no FMT‐related bacteremia. After FMT, 25% of patients with underlying inflammatory bowel disease had worsening disease activity, while 14% of cytomegalovirus‐seropositive patients had reactivation. At 3 months, primary cure was 58.7%, while overall cure was 91.3%. Predictors of failing a single FMT included inpatient status, severe and fulminant CDI, presence of pseudomembranous colitis, and use of non‐CDI antibiotics at the time of FMT. These data suggest FMT is safe in SOT patients. However, repeated FMT(s) or additional antibiotics may be needed to optimize rates of cure with FMT. Fecal microbiota transplantation (FMT) for the treatment of Clostridium difficile infection in patients with a history of solid organ transplantation is associated with low adverse event rates and high rates of cure, especially with repeat FMT(s) and/or additional antibiotics.