Fecal microbiota transplantation for acute graft-versus-host disease of the gut.

Advances in microbial analysis have provided new insights into the complex interactions between the host and gut microbiota. An imbalance in the gut microbiota (dysbiosis) is associated with various disorders and their pathogenesis. Furthermore, in allogeneic stem cell transplantation, increasing evidence indicates that the gut microbiota is closely associated with acute graft-versus-host disease (GVHD) and transplant outcomes, suggesting that its manipulation could be a new treatment strategy for this acute condition. We conducted a feasibility study of fecal microbiota transplantation (FMT) for acute GVHD of the gut in four human transplant recipients. No severe adverse events that were obviously attributable to FMT were observed. All patients responded to FMT: three patients showed a complete response and one a partial response. Our results indicate that FMT could be a new treatment option for acute GVHD of the gut. However, the use of FMT in treating acute GVHD is in the initial stages of clinical application. FMT has limitations that need to be addressed, such as safety and determination of the optimal donor screening or the treatment protocol. Further evaluation is thus warranted.