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 accessAbstract
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
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Cites
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Claims the paper makes
41 Not checked yet · 9 Own interpretation
In the paper
“Several case reports have indicated that there might be some undetermined link between FMT and certain conditions, including peripheral neuropathy, idiopathic thrombocytopenic purpura, Sjo ¨gren's syndrome, and rheumatoid arthritis.17”
§ Fecal microbiota transplantation: Review and update > Patients monitoring and safety issues
What the sources say
- Not checked yetcites [17] Brandt, 2012, Long-term follow-up of colonoscopic fecal microbiota transplant for recurrent Clostridium difficile infection, Am J Gastroenterol source
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Currently, several randomized clinical trials and meta-analysis demonstrated that frozen FMT has the same efficacy as fresh FMT in clinical improvement of recurrent or refractory CDI.57e59”
§ Fecal microbiota transplantation: Review and update > Fecal preparation
What the sources say
- Not checked yetcites 57e59
boosted- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“However, response rates have not been as impressive as FMT for the indication of CDI.”
§ Fecal microbiota transplantation: Review and update > Indications and contraindications
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“Youngster et al. conducted a randomized pilot study comparing upper and lower GI routes of FMT, and the report found a non-significant difference in cure rate between the two different administration methods.67”
§ Fecal microbiota transplantation: Review and update > Delivery methods
What the sources say
- Not checked yetcites [67] Youngster, 2014, Fecal microbiota transplant for relapsing Clostridium difficile infection using a frozen inoculum from unrelated donors: a randomized, open-label, controlled pilot study, Clin Infect Dis source
plain- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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In the paper
“Promising case reports and increasing clinical trials demonstrated that FMT may play a useful primary therapeutic role.27e30”
§ Fecal microbiota transplantation: Review and update > Indications and contraindications
What the sources say
- Not checked yetcites 27e30
hedgedconditional- Asserted: passes — The authors put it forward as true.
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In the paper
“Vrieze and colleagues administered FMT in patients with metabolic syndrome, and a significant increase in insulin sensitivity in these subjects was proven after treatment.40”
§ Fecal microbiota transplantation: Review and update > Indications and contraindications
What the sources say
- Not checked yetcites [40] Vrieze, 2012, Transfer of intestinal microbiota from lean donors increases insulin sensitivity in individuals with metabolic syndrome, Gastroenterology source
boosteddirect- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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None of the sources cited for this claim have been checked yet.
In the paper
“Between the different FMT delivery methods, there were no observed differences in the proportion of adverse events.57,58,68”
§ Fecal microbiota transplantation: Review and update > Patients monitoring and safety issues
What the sources say
- Not checked yetcites [57] Tang, 2017, Is frozen fecal microbiota transplantation as effective as fresh fecal microbiota transplantation in patients with recurrent or refractory Clostridium difficile infection: a meta-analysis?, Diagn Microbiol Infect Dis source
- Not checked yetcites [58] Lee, 2016, Frozen vs fresh fecal microbiota transplantation and clinical resolution of diarrhea in patients with recurrent Clostridium difficile infection: a randomized clinical trial, JAMA source
- Not checked yetcites [68] Kao, 2017, Effect of oral capsule- vs colonoscopy-delivered fecal microbiota transplantation on recurrent Clostridium difficile infection: a randomized clinical trial, JAMA source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“Therefore, modified strategies of FMT use, step-up or intensive-dosing multidonor FMT, were performed in IBD patients and indicated beneficial treatment responses.30,31”
§ Fecal microbiota transplantation: Review and update > Indications and contraindications
What the sources say
- Not checked yetcites [30] Paramsothy, 2017, Multidonor intensive faecal microbiota transplantation for active ulcerative colitis: a randomised placebo-controlled trial, Lancet source
- Not checked yetcites [31] Cui, 2015, Step-up fecal microbiota transplantation strategy: a pilot study for steroid-dependent ulcerative colitis, J Transl Med source
hedgeddirect- Asserted: passes — The authors put it forward as true.
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In the paper
“Unrelated FMT volunteer donors may be more beneficial in cases where genetics play a contributing factor in the disease, like IBD. 55”
§ Fecal microbiota transplantation: Review and update > Donor selection
What the sources say
- Not checked yetcites [55] Kelly, 2015, Update on fecal microbiota transplantation 2015: indications, methodologies, mechanisms, and outlook, Gastroenterology source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“US FDA has approved that FMT is composed of a biological product and a drug applied to diagnose, ease, treat, or prevent disease or influence the structure or function of the body.26”
§ Fecal microbiota transplantation: Review and update > Regulation
What the sources say
- Not checked yetcites [26] U.S. Food and Drug Administration. Enforcement Policy Regarding Investigational New Drug Requirements for Use of Fecal Microbiota for Transplantation to Treat Clostridium difficile Infection Not Responsive to Standard Therapies.
plain- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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In the paper
“Several meta-analysis and cohort studies have shown improved bowel movement in irritable bowel syndrome patients after FMT.18,34e36”
§ Fecal microbiota transplantation: Review and update > Indications and contraindications
What the sources say
- Not checked yetcites 18,34e36
plaindirect- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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In the paper
“Moreover, Kao et al. demonstrated that FMT via oral capsules had comparable outcomes to delivery by colonoscopy in prevention of recurrent CDI.68”
§ Fecal microbiota transplantation: Review and update > Delivery methods
What the sources say
- Not checked yetcites [68] Kao, 2017, Effect of oral capsule- vs colonoscopy-delivered fecal microbiota transplantation on recurrent Clostridium difficile infection: a randomized clinical trial, JAMA source
boosted- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“Furthermore, recent studies also demonstrated the positive effects of immunotherapy on melanoma with FMT in an animal model and clinical trial.45,46”
§ Fecal microbiota transplantation: Review and update > Indications and contraindications
What the sources say
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“Nevertheless, additional clinical evidence has proven no association between donor and FMT outcomes.53,54”
§ Fecal microbiota transplantation: Review and update > Donor selection
What the sources say
- Not checked yetcites [53] Weingarden, 2014, Microbiota transplantation restores normal fecal bile acid composition in recurrent Clostridium difficile infection, Am J Physiol Gastrointest Liver Physiol source
- Not checked yetcites [54] Shankar, 2014, Species and genus level resolution analysis of gut microbiota in Clostridium difficile patients following fecal microbiota transplantation, Microbiome source
boosted- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
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- Based: passes — The paper gives a reason why it holds.
In the paper
“However, another systemic review and meta-analysis study showed that the lower GI route had higher clinical resolution rates than the upper GI route in CDI patients.25”
§ Fecal microbiota transplantation: Review and update > Delivery methods
What the sources say
- Not checked yetcites [25] Kassam, 2013, Fecal microbiota transplantation for Clostridium difficile infection: systematic review and meta-analysis, Am J Gastroenterol source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Moreover, some case reports and cohort studies showed that small populations of patients experienced IBD flares after FMT.72e74”
§ Fecal microbiota transplantation: Review and update > Patients monitoring and safety issues
What the sources say
- Not checked yetcites 72e74
plaincorrelational- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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In the paper
“As a result, it is now already listed in several expert guidelines of standard practice for treating recurrent and refractory CDI, 10”
§ Fecal microbiota transplantation: Review and update > Indications and contraindications
What the sources say
- Not checked yetcites [10] Surawicz, 2013, Guidelines for diagnosis, treatment, and prevention of Clostridium difficile infections, Am J Gastroenterol source
plain- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
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In the paper
“Currently, multiple studies have proven FMT as a successful therapy for recurrent and refractory CDI, even in patients who have comorbid conditions or are immunosuppressed.11e13”
§ Fecal microbiota transplantation: Review and update > Introduction
What the sources say
- Not checked yetcites 11e13
boosteddirect- Asserted: passes — The authors put it forward as true.
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In the paper
“In contrast, there is no known absolute contraindication for FMT based on the current clinical evidence.11”
§ Fecal microbiota transplantation: Review and update > Indications and contraindications
What the sources say
- Not checked yetcites [11] Kelly, 2014, Fecal microbiota transplant for treatment of Clostridium difficile infection in immunocompromised patients, Am J Gastroenterol source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In short, no current strong evidence of the optimal FMT delivery method has been proven in clinical practice, and the decision of the appropriate method should depend on the individual clinical situation.”
§ Fecal microbiota transplantation: Review and update > Delivery methods
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Since 2013, when the United States Food and Drug Administration approved FMT for treating recurrent and refractory Clostridium difficile infection.”
- Also stated in: § Indications and contraindications · plain
“it is the only indication approved by the United States (US) Food and Drug Administration (FDA) since 2013.26”
§ Fecal microbiota transplantation: Review and update > Abstract
What the sources say
- Not checked yetcites [26] U.S. Food and Drug Administration. Enforcement Policy Regarding Investigational New Drug Requirements for Use of Fecal Microbiota for Transplantation to Treat Clostridium difficile Infection Not Responsive to Standard Therapies.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § Indications and contraindications · plain
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Currently, the definite periodicity and length of follow-up after FMT for monitoring of long-term adverse events are not established.”
§ Fecal microbiota transplantation: Review and update > Patients monitoring and safety issues
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Most current clinical experience with FMT has originated from treatment of recurrent or refractory CDI.21”
§ Fecal microbiota transplantation: Review and update > Indications and contraindications
What the sources say
- Not checked yetcites [21] Smits, 2013, Therapeutic potential of fecal microbiota transplantation, Gastroenterology source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Nevertheless, the appropriate volume of fecal infusion is difficult to define.”
§ Fecal microbiota transplantation: Review and update > Fecal preparation
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The definite mechanism of IBD flare after FMT is still unclear, although Quera et al. suggested that transient bacteremia may result in altered intestinal permeability, resulting in a flare.74”
§ Fecal microbiota transplantation: Review and update > Patients monitoring and safety issues
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Although current evidence deems FMT as a generally safe therapeutic method with few adverse effects, the longterm outcomes of FMT have not been completely elucidated.”
- Also stated in: § Patients monitoring and safety issues · plain
“Until now, the long-term outcomes of FMT have not been completely comprehended.”
§ Fecal microbiota transplantation: Review and update > Abstract
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § Patients monitoring and safety issues · plain
In the paper
“Els et al. carried out the first randomized controlled trial in 2013.The study showed that duodenal infusion of donor feces in patients with recurrent CDI had more significant efficacy in resolving symptoms than antibiotics use alone.19”
§ Fecal microbiota transplantation: Review and update > History of fecal microbiota transplantation
What the sources say
- Not checked yetcites [19] van Nood, 2013, Duodenal infusion of donor feces for recurrent Clostridium difficile, N Engl J Med source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“another uncertainty of FMT is the highly dynamic composition of live microbiota, which is sensitive to external factors such as diet and drugs.6”
§ Fecal microbiota transplantation: Review and update > Challenges and future considerations
What the sources say
- Not checked yetcites [6] David, 2014, Diet rapidly and reproducibly alters the human gut microbiome, Nature source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
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- Based: passes — The paper gives a reason why it holds.
- It may state two separate claims as one. 17
- Probably not a substantial claim. 7
In the paper
“A multicenter, retrospective study examined FMT in 80 immunocompromised patients of CDI.There were not only absent infection events related to FMT occurring, but also high cure rates of 78% following a single FMT.11”
§ Fecal microbiota transplantation: Review and update > Patients monitoring and safety issues
What the sources say
- Not checked yetcites [11] Kelly, 2014, Fecal microbiota transplant for treatment of Clostridium difficile infection in immunocompromised patients, Am J Gastroenterol source
plainn = 80- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Larger volumes of fecal material have shown better FMT outcomes in CDI patients, as demonstrated by a systemic review article, and up to a four-fold higher risk for failure was noted for infusion volumes less than 50 g compared to the larger volume.24”
§ Fecal microbiota transplantation: Review and update > Fecal preparation
What the sources say
- Not checked yetcites [24] Gough, 2011, Systematic review of intestinal microbiota transplantation (fecal bacteriotherapy) for recurrent Clostridium difficile infection, Clin Infect Dis source
boostedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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It may state two separate claims as one.
In the paper
“The European consensus proposed that the follow-up period after FMT in CDI patients should be at least 8 weeks, and the contents of follow-up must include clinical and analytical data.49”
§ Fecal microbiota transplantation: Review and update > Patients monitoring and safety issues
What the sources say
- Not checked yetcites [49] Cammarota, 2017, European consensus conference on faecal microbiota transplantation in clinical practice, Gut source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“The cure rate is surprisingly up to approximately 90% in recurrent or refractory CDI, which is much superior to prolonged anti-microbial therapy with 20e30% success rates.19,24,25”
§ Fecal microbiota transplantation: Review and update > Indications and contraindications
What the sources say
- Not checked yetcites [19] van Nood, 2013, Duodenal infusion of donor feces for recurrent Clostridium difficile, N Engl J Med source
- Not checked yetcites [24] Gough, 2011, Systematic review of intestinal microbiota transplantation (fecal bacteriotherapy) for recurrent Clostridium difficile infection, Clin Infect Dis source
- Not checked yetcites [25] Kassam, 2013, Fecal microbiota transplantation for Clostridium difficile infection: systematic review and meta-analysis, Am J Gastroenterol source
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Furthermore, current studies demonstrated FMT can be a cost-saving intervention in managing recurrent and refractory compared to antibiotics use and in moderate-to-severe IBD treatment.32,33”
§ Fecal microbiota transplantation: Review and update > Indications and contraindications
What the sources say
- Not checked yetcites [32] Zhang, 2017, Cost-effectiveness analysis of fecal microbiota transplantation for inflammatory bowel disease, Oncotarget source
- Not checked yetcites [33] Varier, 2015, Cost-effectiveness analysis of fecal microbiota transplantation for recurrent Clostridium difficile infection, Infect Control Hosp Epidemiol source
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Most clinical trials and systemic reviews presented that some minor adverse events, such as abdominal discomfort, diarrhea, constipation, and low-grade fever, were transiently noted after FMT, and uncommon severe side effects were often associated with the possible complications of endoscopy and sedation.17,19,66,70,71”
§ Fecal microbiota transplantation: Review and update > Patients monitoring and safety issues
What the sources say
- Not checked yetcites [17] Brandt, 2012, Long-term follow-up of colonoscopic fecal microbiota transplant for recurrent Clostridium difficile infection, Am J Gastroenterol source
- Not checked yetcites [19] van Nood, 2013, Duodenal infusion of donor feces for recurrent Clostridium difficile, N Engl J Med source
- Not checked yetcites [66] Cammarota, 2014, Fecal microbiota transplantation for the treatment of Clostridium difficile infection: a systematic review, J Clin Gastroenterol source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Several case reports and animal models have also revealed the probable therapeutic effects of FMT in patients with severe multiple sclerosis, 41 autism, 42 multidrug-resistant organisms (MDRO) infections, 43 and multiple organ dysfunction in critical patients.44”
§ Fecal microbiota transplantation: Review and update > Indications and contraindications
What the sources say
- Not checked yetcites [41] Xu, 2015, Fecal microbiota transplantation broadening its application beyond intestinal disorders, World J Gastroenterol source
- Not checked yetcites [42] Aroniadis, 2013, Fecal microbiota transplantation: past, present and future, Curr Opin Gastroenterol source
- Not checked yetcites [43] Crum-Cianflone, 2015, Fecal microbiota transplantation and successful resolution of multidrug-resistant-organism colonization, J Clin Microbiol source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Although the efficacy of retention enema had been once doubted, Orenstein and Dubberke et al. have proven it more efficient and safe than placebo in phase I and phase II recurrent CDI clinical trials.64,65”
§ Fecal microbiota transplantation: Review and update > Delivery methods
What the sources say
- Not checked yetcites [64] Orenstein, 2016, Safety and durability of RBX2660 (microbiota suspension) for recurrent Clostridium difficile infection: results of the PUNCH CD study, Clin Infect Dis source
- Not checked yetcites [65] Dubberke, 2018, Results from a randomized placebo-controlled clinical trial of a RBX2660-a microbiota-based drug for the prevention of recurrent Clostridium difficile infection, Clin Infect Dis source
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Based on current evidence, FMT is viewed as a generally safe therapeutic method with few adverse effects.”
§ Fecal microbiota transplantation: Review and update > Patients monitoring and safety issues
plainn = 80- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“In the United Kingdom, FMT is also approved for treating CDI, and it is considered safe and effective.14”
§ Fecal microbiota transplantation: Review and update > Regulation
What the sources say
- Not checked yetcites [14] Smith, 2014, Policy: how to regulate faecal transplants, Nature source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Many different groups of diseases are connected to the gut microbiota, including infectious conditions (infectious gastroenteritis, Clostridium difficile infection (CDI)), autoimmune diseases (allergic disease, diabetes, inflammatory bowel disease (IBD)), some general conditions (overweight, functional GI disorders), and behavioral diseases.8”
§ Fecal microbiota transplantation: Review and update > Introduction
What the sources say
- Not checked yetcites [8] Collado, 2015, Gut microbiota: a source of novel tools to reduce the risk of human disease?, Pediatr Res source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“The first records of FMT has been traced back to the fourth century China, where human fecal material was called yellow soup and was used in patients of severe diarrhea.15”
§ Fecal microbiota transplantation: Review and update > History of fecal microbiota transplantation
What the sources say
- Not checked yetcites [15] Zhang, 2012, Should we standardize the 1,700-year-old fecal microbiota transplantation?, Am J Gastroenterol source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Borody et al. performed “an exchange of bowel flora” on a 45year old male with refractory ulcerative colitis (UC), showing full and lasting clinical recovery after treatment.20”
§ Fecal microbiota transplantation: Review and update > History of fecal microbiota transplantation
What the sources say
- Not checked yetcites [20] Borody, 1989, Bowel-flora alteration: a potential cure for inflammatory bowel disease and irritable bowel syndrome?, Med J Aust source
plaindirectSingle case- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“From a clinical and research perspective, any FMT application beyond treating CDI is deemed “offlabel”; therefore, the benefits and risks of clinical practice must be carefully considered.52”
§ Fecal microbiota transplantation: Review and update > Regulation
What the sources say
- Not checked yetcites [52] Vindigni, 2017, Fecal microbiota transplantation, Gastroenterol Clin N Am source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Some studies suggested loperamide use one hour before FMT in order to ensure that the transplanted feces stay at least 4 h long in the intestines.61e63”
§ Fecal microbiota transplantation: Review and update > Recurrent and refractory Clostridium difficile infection Indications in investigation and potential indications
What the sources say
- Not checked yetcites 61e63
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“The human gastrointestinal (GI) tract is colonized by numerous bacterial species, which have the function of aiding digestion, assisting in nutritional provision, facilitating maturation of the colonic epithelium, and protection from pathogens.1e3”
§ Fecal microbiota transplantation: Review and update > Introduction
What the sources say
- Not checked yetcites 1e3
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“Human gut microbiome differs by individual and is relatively stable and resilient over time; however, environmental factors, including diet, probiotics, prebiotics, viruses, and drugs, particularly antibiotics, can alter the composition.4e7”
§ Fecal microbiota transplantation: Review and update > Introduction
What the sources say
- Not checked yetcites 4e7
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Multiple studies have demonstrated remarkable effectiveness of FMT in cases of recurrent and refractory CDI, which may be attributed to sustained restoration of the normal microbiota after FMT.22,23”
§ Fecal microbiota transplantation: Review and update > Indications and contraindications
What the sources say
- Not checked yetcites [22] Khoruts, 2010, Changes in the composition of the human fecal microbiome after bacteriotherapy for recurrent Clostridium difficile-associated diarrhea, J Clin Gastroenterol source
- Not checked yetcites [23] Hamilton, 2012, Standardized frozen preparation for transplantation of fecal microbiota for recurrent Clostridium difficile infection, Am J Gastroenterol source
boostedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Health Canada regards FMT as a “New Biologic Drug” and declares that all clinical studies must pass the process of a clinical trial application to ensure it meets quality and safety standards.75”
§ Fecal microbiota transplantation: Review and update > Regulation
What the sources say
- Not checked yetcites [75] Allen-Vercoe, 2012, A Canadian Working Group report on fecal microbial therapy: microbial ecosystems therapeutics, Can J Gastroenterol source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“However, long-term immunologic effects of FMT is another concern, but very little relevant information is available.”
§ Fecal microbiota transplantation: Review and update > Patients monitoring and safety issues
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The optimal preparation of fecal material to manage remains to be determined.”
§ Fecal microbiota transplantation: Review and update > Fecal preparation
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
In the paper
“Eiseman and his colleagues successfully treated patients with FMT for pseudomembranous colitis in 1958, the first report in the medical literature.16”
§ Fecal microbiota transplantation: Review and update > History of fecal microbiota transplantation
What the sources say
- Not checked yetcites [16] Eiseman, 1958, Fecal enema as an adjunct in the treatment of pseudomembranous enterocolitis, Surgery
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
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)”
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?
In the citing paper
“Despite the therapeutic potential of FMT for the treatment of PD, several limitations still exist and need to be addressed. Standard clinical protocols, delivery methods, periodicity, donor’s selection criteria, patient’s inclusion criteria, long-term benefits and potential risks remain an issue [463,467,481,482,483,484,485].”
From The Interplay between Gut Microbiota and Parkinson’s Disease: Implications on Diagnosis and Treatment (2022) · cites this paper as [485]
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.
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Fecal microbiota transplantation: Review and update > Challenges and future considerations
“Abbreviations: FMT: fecal material transplantation, HIV: human immunodeficiency virus, IBD: Inflammatory bowel disease.”
§ Fecal microbiota transplantation: Review and update > 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.”
Citations
Cites
An obesity-associated gut microbiome with increased capacity for energy harvest
Turnbaugh, P. J., Ley, R. E., Mahowald, M. A., Magrini, V., Mardis, E. R., & Gordon, J. I. (2006) · Nature · doi:10.1038/nature05414 · Cited by 12,444
Diet rapidly and reproducibly alters the human gut microbiome
David, L. A., Maurice, C. F., Carmody, R. N., Gootenberg, D. B., Button, J. E., Wolfe, B. E., Ling, A. V., Devlin, A. S., Varma, Y., Fischbach, M. A., et al. (2014) · Nature · doi:10.1038/nature12820 · Cited by 10,100
Obesity alters gut microbial ecology
Ley, R. E., Bäckhed, F., Turnbaugh, P., Lozupone, C. A., Knight, R. D., & Gordon, J. I. (2005) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.0504978102 · Cited by 6,176
Gut microbiome influences efficacy of PD-1-based immunotherapy against epithelial tumors
Routy, B., Le Chatelier, E., Derosa, L., Duong, C. P. M., Alou, M. T., Daillère, R., Fluckiger, A., Messaoudene, M., Rauber, C., Roberti, M. P., et al. (2018) · Science · doi:10.1126/science.aan3706 · Cited by 5,671
Gut microbiome modulates response to anti-PD-1 immunotherapy in melanoma patients
Gopalakrishnan, V., Spencer, C. N., Nezi, L., Reuben, A., Andrews, M. C., Karpinets, T. V., Prieto, P. A., Vicente, D., Hoffman, K., Wei, S. C., et al. (2018) · Science · doi:10.1126/science.aan4236 · Cited by 4,812
Duodenal Infusion of Donor Feces for Recurrent Clostridium difficile
van Nood, E., Vrieze, A., Nieuwdorp, M., Fuentes, S., Zoetendal, E. G., de Vos, W. M., Visser, C. E., Kuijper, E. J., Bartelsman, J. F. W. M., Tijssen, J. G. P., et al. (2013) · New England Journal of Medicine · doi:10.1056/nejmoa1205037 · Cited by 3,708
Vrieze, A., Van Nood, E., Holleman, F., Salojärvi, J., Kootte, R. S., Bartelsman, J. F. W. M., Dallinga–Thie, G. M., Ackermans, M. T., Serlie, M. J., Oozeer, R., et al. (2012) · Gastroenterology · doi:10.1053/j.gastro.2012.06.031 · Cited by 2,913
Mechanisms underlying the resistance to diet-induced obesity in germ-free mice
Bäckhed, F., Manchester, J. K., Semenkovich, C. F., & Gordon, J. I. (2007) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.0605374104 · Cited by 2,615
Guidelines for diagnosis, treatment, and prevention of Clostridium difficile infections
Surawicz, C. M., Brandt, L. J., Binion, D. G., Ananthakrishnan, A. N., Curry, S. R., Gilligan, P. H., McFarland, L. V., Mellow, M., & Zuckerbraun, B. S. (2013) · American Journal of Gastroenterology · doi:10.1038/ajg.2013.4 · Cited by 1,645
Paramsothy, S., Kamm, M. A., Kaakoush, N. O., Walsh, A. J., van den Bogaerde, J., Samuel, D., Leong, R. W. L., Connor, S., Ng, W., Paramsothy, R., et al. (2017) · The Lancet · doi:10.1016/s0140-6736(17)30182-4 · Cited by 1,276
Cited by
Sorted by citations
Microbiome definition re-visited: old concepts and new challenges
Berg, G., Rybakova, D., Fischer, D., Cernava, T., Vergès, M.-C. C., Charles, T., Chen, X., Cocolin, L., Eversole, K., Corral, G. H., et al. (2020) · Microbiome · doi:10.1186/s40168-020-00875-0 · Cited by 2,275
The Intestinal Microbiota and Colorectal Cancer
Cheng, Y., Ling, Z., & Li, L. (2020) · Frontiers in Immunology · doi:10.3389/fimmu.2020.615056 · Cited by 609
Wang, H., Rong, X., Zhao, G., Zhou, Y., Xiao, Y., Ma, D., Jin, X., Wu, Y., Yan, Y., Yang, H., et al. (2022) · Cell Metabolism · doi:10.1016/j.cmet.2022.02.010 · Cited by 411
Gut microbiome and its role in colorectal cancer
Reberšek, M. (2021) · BMC Cancer · doi:10.1186/s12885-021-09054-2 · Cited by 365
The mutual interplay of gut microbiota, diet and human disease
Illiano, P., Brambilla, R., & Parolini, C. (2020) · FEBS Journal · doi:10.1111/febs.15217 · Cited by 338
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
- ORCID
- 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
- gold
- doi.org
- Licence
- 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
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
A language model drew the claims from the paper on 2026-10-07, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).
A second model labelled each claim on 2026-10-07 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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