Cited by 250Clostridium difficile and Clostridium perfringens researchGut microbiota and healthGastrointestinal motility and disorders

Systematic review: the global incidence of faecal microbiota transplantation-related adverse events from 2000 to 2020

Marcella, Cicilia, Cui, Bota, Kelly, Colleen R., Ianiro, Gianluca, Cammarota, Giovanni, Zhang, Faming·2021·Alimentary Pharmacology & Therapeutics

Abstract

BACKGROUND: Faecal microbiota transplantation (FMT) is an effective treatment in C. difficile infection (CDI) and is currently being investigated in other diseases. There is concern around the safety of FMT and that side effects or complications may be under-reported in the medical literature. AIM: To evaluate the safety of FMT by summarising the overall reported Adverse Events (AEs) over a 20-year period METHODS: We searched EMBASE, MEDLINE, and Cochrane Library databases, and CNKI and Wanfang Data from January 2000 to April 2020. All original studies reporting FMT-related AEs were considered for inclusion. FMT-related AEs were further classified as delivery-related or microbiota-related. RESULTS: Based on the inclusion criteria, 129 studies, which included 4241 patients (5688 FMT courses), were finally eligible. The most common indication for FMT was CDI. Overall, FMT-related AEs were observed in 19% of FMT procedures. The most frequently reported FMT-related AEs were diarrhoea (10%) and abdominal discomfort/pain/cramping (7%). FMT-related serious adverse events (SAEs), including infections and deaths, have been reported in 1.4% of patients who underwent FMT (0.99% microbiota-related SAEs). Four of five FMT-related deaths were reported in patients receiving FMT via the upper gastrointestinal route. Importantly, all reported FMT-related SAEs were in patients with mucosal barrier injury. CONCLUSION: Most FMT-related AEs were mild or moderate and self-limiting. Although FMT appears to be highly safe, its methodology should be improved to reduce both delivery-related AEs and, microbiota-related AEs.

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Crossref · 10.1111/apt.16148

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Authors
Marcella, C., Cui, B., Kelly, C. R., Ianiro, G., Cammarota, G., & Zhang, F.
Affiliations
  • Second Affiliated Hospital of Nanjing Medical University (CN)
  • Brown University (US)
  • Università Cattolica del Sacro Cuore (IT)
Corresponding author
Zhang, Faming
Venue
Alimentary Pharmacology & Therapeutics
Publisher
Wiley
Published
2020-11-07
Volume
53
Issue
1
Pages
33-42
ISSN
  • 0269-2813 (ISSN-L)
  • 1365-2036
OpenAlex
W3097320816
Cited by
250
References
74
Citations by year
2026: 39 · 2025: 46 · 2024: 52 · 2023: 48 · 2022: 38 · 2021: 24 · 2020: 2
FWCI
1.32
Type
journal article
Language
en
Open access
closed
Locations
  • Alimentary Pharmacology & Therapeutics (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Infectious Diseases › Clostridium difficile and Clostridium perfringens research
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
  • Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
Keywords
fecal microbiota transplantation, adverse events, Clostridium difficile infection, diarrhea, abdominal pain, serious adverse events, mucosal barrier injury
MeSH terms
Fecal Microbiota Transplantation, Clostridium Infections, Diarrhea, Feces, Humans, Recurrence, Incidence, Clostridioides difficile, Treatment Outcome

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