Sudarshan Paramsothy1, Thomas J Borody, Enmoore Lin, Sarah Finlayson, Alissa J Walsh, Douglas Samuel, Johan van den Bogaerde, Rupert W L Leong, Susan Connor, Watson Ng, Hazel M Mitchell, Nadeem Kaakoush, Michael A Kamm. 1. *Department of Gastroenterology and Hepatology, St Vincent's Hospital, Sydney, Australia; †Department of Gastroenterology and Hepatology, Bankstown Lidcombe Hospital, Sydney, Australia; ‡Department of Gastroenterology and Hepatology, Nambour General Hospital, Nambour, Australia; §School of Biotechnology and Biomolecular Sciences, University of New South Wales, Sydney, Australia; ‖Centre for Digestive Diseases, Sydney, Australia; ¶Department of Gastroenterology and Hepatology, Liverpool Hospital, Sydney, Australia; **Department of Gastroenterology and Hepatology, St Vincent's Hospital Melbourne and University of Melbourne, Melbourne, Australia; and ††Imperial College London, London, United Kingdom.
Abstract
BACKGROUND: Increasing demand for fecal microbiota transplantation (FMT) has created a need for stool banks sourced from long-term healthy donors. Here, we describe our experience in recruiting and screening fecal donors. METHODS: Mailbox, newspaper, and online advertisements were used. Potential donors were required to satisfy a prescreen telephone conversation, pass blood and stool investigations, then undertake a screening interview including medical history, physical examination, and evaluation of donor selection criteria. RESULTS:One hundred sixteen potential donors were prescreened of whom 74 failed-47 declined based on study donation requirements (primarily related to frequency and duration of donations), 13 had medical comorbidities, 6 variant Creutzfeldt-Jakob disease risk factors, 8 for other reasons. Thirty-eight completed stool and blood testing-1 failed blood testing (indeterminate hepatitis C serology), whereas 15 failed stool investigations (5 Dientamoeba fragilis, 5 Blastocystis hominis, 1 B. hominis and D. fragilis, 1 Giardia intestinalis plus D. fragilis, 1 Norovirus plus Clostridium difficile toxin positive, and 2 leucocytes or erythrocytes on stool microscopy). Of the 18 potential donors proceeding to screening interview, 6 were excluded (3 body mass index >30, 1 illicit drug use, 1 uncontrolled anxiety and concerns regarding compliance, 1 irregular bowel movements after new medication commencement). In total, only 12 of 116 (10%) potential donors were enrolled as study donors. CONCLUSIONS: Recruitment of fecal donors for FMT is challenging with only a small percentage ultimately serving as donors. Many were unable or unwilling to meet the donor commitment requirements. A surprisingly large proportion of healthy asymptomatic donors failed stool testing, primarily due to gastrointestinal parasites.
RCT Entities:
BACKGROUND: Increasing demand for fecal microbiota transplantation (FMT) has created a need for stool banks sourced from long-term healthy donors. Here, we describe our experience in recruiting and screening fecal donors. METHODS: Mailbox, newspaper, and online advertisements were used. Potential donors were required to satisfy a prescreen telephone conversation, pass blood and stool investigations, then undertake a screening interview including medical history, physical examination, and evaluation of donor selection criteria. RESULTS: One hundred sixteen potential donors were prescreened of whom 74 failed-47 declined based on study donation requirements (primarily related to frequency and duration of donations), 13 had medical comorbidities, 6 variant Creutzfeldt-Jakob disease risk factors, 8 for other reasons. Thirty-eight completed stool and blood testing-1 failed blood testing (indeterminate hepatitis C serology), whereas 15 failed stool investigations (5 Dientamoeba fragilis, 5 Blastocystis hominis, 1 B. hominis and D. fragilis, 1 Giardia intestinalis plus D. fragilis, 1 Norovirus plus Clostridium difficile toxin positive, and 2 leucocytes or erythrocytes on stool microscopy). Of the 18 potential donors proceeding to screening interview, 6 were excluded (3 body mass index >30, 1 illicit drug use, 1 uncontrolled anxiety and concerns regarding compliance, 1 irregular bowel movements after new medication commencement). In total, only 12 of 116 (10%) potential donors were enrolled as study donors. CONCLUSIONS: Recruitment of fecal donors for FMT is challenging with only a small percentage ultimately serving as donors. Many were unable or unwilling to meet the donor commitment requirements. A surprisingly large proportion of healthy asymptomatic donors failed stool testing, primarily due to gastrointestinal parasites.
Authors: Michael H Woodworth; Emma M Neish; Nancy S Miller; Tanvi Dhere; Eileen M Burd; Cynthia Carpentieri; Kaitlin L Sitchenko; Colleen S Kraft Journal: J Clin Microbiol Date: 2017-01-11 Impact factor: 5.948