Washed microbiota transplantation

What is it about?

Fecal microbiota transplantation (FMT) has been used in clinical medicine for over one thousand years. However, the safety, quantitative method and delivery of FMT vary a lot from different countries in practice.Recently, the improved methodology of FMT based on the automatic filtration, washing process and the related delivery was named as washed microbiota transplantation (WMT). Our study aimed to describe the methodology development of FMT from manual to washing preparation from 2012 to 2021 in China Microbiota Transplantation System (CMTS), a centralized stool bank for providing a national non-profit service. Donor screening, washing process, dose, time, frequency, and delivery were all closely related to the safety and efficacy of WMT.

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Photo by julien Tromeur on Unsplash

Photo by julien Tromeur on Unsplash

Why is it important?

The present study should help improve the better practice of FMT for helping more patients in the future. We showed that the success rate of donor screening was 3.1% (32/1036). The incidence rate of fever decreased significantly from 19.4% (6/31) in manual FMT to 2.7% (24/902) in WMT in patients with ulcerative colitis (UC), which made UC a considerable mucosal-barrier-injury-disease model to reflect the quality control of fecal microbiota preparation. We defined one treatment unit as 10 cm^3 microbiota precipitation (1.0 × 10^13 bacteria) based on enriched microbiota instead of rough fecal weight. For delivering microbiota, colonic transendoscopic enteral tube is a promising way especially for multiple WMTs or frequent colonic administration of drugs combined with WMT.

Perspectives