Cited by 576Gut microbiota and healthClostridium difficile and Clostridium perfringens researchGastrointestinal motility and disorders

The DOI matches its Crossref record; 75 of the 75 references it cites were found in a registry or an index; none of the 55 sources its claims cite is checked for support yet.

Fecal microbiota transplantation: Review and update

Open access

Abstract

Fecal microbiota transplantation (FMT) is a method to directly change the recipient's gut microbiota to normalize the composition and gain a therapeutic benefit. The history of FMT has been traced back to the 4th century and has been highly regarded since 2013, when the United States Food and Drug Administration approved FMT for treating recurrent and refractory Clostridium difficile infection. Since then, the range of FMT applications extended rapidly and broadly not only in gastrointestinal disorders, but also in extra-gastrointestinal diseases. Donor selection with questionnaire, interview, blood tests, and stool examinations should be strictly performed before FMT to reduce and prevent occurrence of any adverse events. Step-by-step cautious fecal and recipient preparation along with adequately choosing delivery methods based on individual clinical situations are key points of the FMT process. Although current evidence deems FMT as a generally safe therapeutic method with few adverse effects, the long-term outcomes of FMT have not been completely elucidated. Therefore, establishing periodicity and length of regular follow-up after FMT to monitor the clinical efficacy and long-term adverse events are other essential issues. In the future, we will look forward to personalized FMT for different patients and conditions according to varied hosts and diseases.

Overview

AI snapshot

Written from the paper’s full text.

TL;DR

FMT directly changes the recipient gut microbiota and is established for recurrent/refractory *Clostridium difficile* infection, with expanding investigation in gastrointestinal and extra-gastrointestinal diseases. This review summarizes FMT history, indications, donor/recipient preparation, delivery, safety, regulation, and future directions, noting that long-term outcomes remain incompletely understood.

Key findings

  • FMT achieves cure rates up to approximately 90% in recurrent or refractory CDI, compared with 20–30% success for prolonged antimicrobial therapy; it is the only indication approved by the US FDA since 2013.
  • Frozen FMT has the same efficacy as fresh FMT for clinical improvement of recurrent or refractory CDI; infusion volumes less than 50 g were associated with up to a four-fold higher risk of failure compared with larger volumes.
  • In 80 immunocompromised CDI patients, a multicenter retrospective study found no FMT-related infection events and 78% cure after a single FMT; minor adverse events include abdominal discomfort, diarrhea, constipation, and low-grade fever.
  • Beyond CDI, FMT is under investigation for IBD, IBS, metabolic syndrome/obesity, autoimmune and neurologic conditions, multidrug-resistant organism infections, critical illness, and melanoma immunotherapy; response rates in IBD are less impressive than in CDI.

Methods

  • Design: narrative review/update; no primary data collection or systematic review methodology is described.
  • Data: published literature, clinical trials, meta-analyses, case reports, and expert guidelines; includes tables on indications, donor inclusion/exclusion criteria, donor screening tests, and adverse events.
  • Analysis: narrative synthesis of FMT history, indications/contraindications, donor selection, fecal and recipient preparation, delivery methods, monitoring/safety, regulation, and future considerations.

Limitations

  • Stated: long-term outcomes of FMT have not been completely elucidated; periodicity and length of follow-up after FMT are not established; long-term immunologic effects have little available information.
  • Stated: optimal fecal preparation remains to be determined, no strong evidence supports an optimal FMT delivery method, and appropriate fecal infusion volume is difficult to define.
  • Evident from the text: as a narrative review, it does not report a systematic search strategy, risk-of-bias assessment, or quantitative synthesis, so findings depend on heterogeneous published studies.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1016/j.jfma.2018.08.011

Cites

75 of 75 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Verification

Claims the paper makes

41 Not checked yet · 9 Own interpretation

Verify all 55 references — free account

Show all 28 claims

  • It may state two separate claims as one. 17
  • Probably not a substantial claim. 7
22 of 22
  • The paper relies on this without support.

    Current therapeutic strategies to correct gut dysbiosis mostly do not present satisfactory clinical effects, except for FMT.

    “Currently, a wide variety of medical therapeutic strategies are used to correct gut dysbiosis, but a great majority of them do not present satisfactory clinical effects, except for fecal microbiota transplantation (FMT).”
  • The paper relies on this without support.

    FMT has clinically evident effectiveness.

    “clinically evident effectiveness and safety of FMT”
  • The paper relies on this without support.

    FMT has clinically evident safety.

    “clinically evident effectiveness and safety of FMT”
  • The paper relies on this without support.

    FMT carries a risk of disease transmission between the donor and recipient.

    “risk of disease transmission between the donor and recipient”
  • The paper relies on this without support.

    Patient acceptance is a concern for FMT.

    “patients' acceptance”
  • The paper relies on this without support.

    FMT can cause undesirable outcomes.

    “undesirable outcomes”
  • The paper relies on this without support.

    FMT has uncertain impacts on the recipient's immune system.

    “uncertain impacts on the recipient's immune system”
  • The paper relies on this without support.

    Little is known about the viral or fungal composition in the gut and the function of intestinal bacteria.

    “little is known about the viral or fungal composition in the gut and even the function of intestinal bacteria”
  • The paper relies on this without support.

    FMT has the potential to transmit unrecognized infectious agents that cause illness years later (e.g., hepatitis C, HIV).

    “Transmission of unrecognized infectious agents that cause illness years later (e.g., hepatitis C, HIV)”
  • The paper relies on this without support.

    FMT has the potential to induce chronic diseases based on alterations in the gut microbiota (e.g., obesity, diabetes, atherosclerosis, IBD, colon cancer, nonalcoholic fatty liver disease, IBS, asthma, autism).

    “Induction of chronic diseases based on alterations in the gut microbiota (e.g., obesity, diabetes, atherosclerosis, IBD, colon cancer, nonalcoholic fatty liver disease, IBS, asthma, autism)”
10 of 10

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

1 of 1

Citations

Cites

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Metadata

Authors
Wang, J.-W., Kuo, C.-H., Kuo, F.-C., Wang, Y.-K., Hsu, W.-H., Yu, F.-J., Hu, H.-M., Hsu, P.-I., Wang, J.-Y., & Wu, D.-C.
Affiliations
  • Kaohsiung Medical University (TW)
  • E-Da Hospital (TW)
  • Kaohsiung Municipal Hsiao-Kang Hospital (TW)
  • Kaohsiung Veterans General Hospital (TW)
Corresponding author
Wu, Deng-Chyang
Venue
Journal of the Formosan Medical Association
Publisher
Elsevier BV
Published
2019-03
Volume
118
Pages
S23-S31
ISSN
0929-6646 (ISSN-L)
OpenAlex
W2889311756
Cited by
576
References
75
Citations by year
2026: 57 · 2025: 121 · 2024: 108 · 2023: 112 · 2022: 85 · 2021: 50 · 2020: 32 · 2019: 11
FWCI
2.28
Type
journal article
Language
en
Open access
Locations
  • Journal of the Formosan Medical Association (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
  • Kaohsiung Municipal Ta-Tung Hospital, Taiwan (KMTTH-106-028)
  • Kaohsiung Medical University Hospital, Taiwan (KMUH106-6R02)
  • Ministry of Health and Welfare, Taiwan (MOHW106-TDU-B-212-113006)
Topics
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
  • Health Sciences › Medicine › Infectious Diseases › Clostridium difficile and Clostridium perfringens research
  • Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
Keywords
fecal microbiota transplantation, gut microbiota, Clostridium difficile infection, donor selection, long-term follow-up, extraintestinal diseases, gastrointestinal diseases
MeSH terms
Fecal Microbiota Transplantation, Clostridium Infections, Gastrointestinal Diseases, Humans, Recurrence, Randomized Controlled Trials as Topic, Clostridioides difficile, Treatment Outcome, Practice Guidelines as Topic

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