International consensus conference on stool banking for faecal microbiota transplantation in clinical practice
Open accessAbstract
infection (CDI), its widespread dissemination is limited by several obstacles, including lack of dedicated centres, difficulties with donor recruitment and complexities related to regulation and safety monitoring. Given the considerable burden of CDI on global healthcare systems, FMT should be widely available to most centres.Stool banks may guarantee reliable, timely and equitable access to FMT for patients and a traceable workflow that ensures safety and quality of procedures. In this consensus project, FMT experts from Europe, North America and Australia gathered and released statements on the following issues related to the stool banking: general principles, objectives and organisation of the stool bank; selection and screening of donors; collection, preparation and storage of faeces; services and clients; registries, monitoring of outcomes and ethical issues; and the evolving role of FMT in clinical practice,Consensus on each statement was achieved through a Delphi process and then in a plenary face-to-face meeting. For each key issue, the best available evidence was assessed, with the aim of providing guidance for the development of stool banks in order to promote accessibility to FMT in clinical practice.
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Stool banks provide widespread and equitable access to FMT together with high safety, quality, and traceable workflows.
“Both the increase in clinical requests for FMT to prevent rCDI and the high level of required quality controls have led to the development of stool banks that provide widespread and equitable access to FMT together with high safety, quality, and traceable workflows. 22”
From Key determinants of success in fecal microbiota transplantation: From microbiome to clinic (2023) · cites this paper as [22]
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Self-citationHealthcare personnel intestinal colonization with multidrug-resistant organisms
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Endoscopic peroral jejunal fecal microbiota transplantation
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Self-citationBanking feces: a new frontier for public blood banks?
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Self-citationExperience and Outcomes at a Specialized Clostridium difficile Clinical Practice
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Fecal Microbiota Transplant for Clostridium difficile Infection in a Pregnant Patient
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Emerging drugs for the treatment of clostridium difficile
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Self-citationStool Colonization of Healthcare Workers with Selected Resistant Bacteria
Carmeli, Y., Venkataraman, L., DeGirolami, P. C., et al. (1998) · Infection Control and Hospital Epidemiology · doi:10.2307/30141355 · Cited by 16 · see citing works
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Ethical aspects of Fecal Microbiota Transplantation (FMT).
Daloiso, V., Minacori, R., Refolo, P., Sacchini, D., Craxì, L., Gasbarrini, A., & Spagnolo, A. G. (2015) · PubMed · Cited by 13 · see citing works
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Self-citationFaecal microbiota transplantation in Australia: bogged down in regulatory uncertainty
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Self-citationThe case for a regulated system of incentives for living kidney donation
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Sorted by citations
ACG Clinical Guidelines: Prevention, Diagnosis, and Treatment of Clostridioides difficile Infections
Kelly, C. R., Fischer, M., Allegretti, J. R., LaPlante, K. L., Stewart, D. B., Limketkai, B. N., & Stollman, N. (2021) · The American Journal of Gastroenterology · doi:10.14309/ajg.0000000000001278 · Cited by 615 · see citing works
Self-citationIaniro, G., Punčochář, M., Karcher, N., Porcari, S., Armanini, F., Asnicar, F., Beghini, F., Blanco-Míguez, A., Cumbo, F., Manghi, P., et al. (2022) · Nature Medicine · doi:10.1038/s41591-022-01964-3 · Cited by 366 · see citing works
“total 24 (3) 226 (23) 1,371 (116) 2 [2]”
Self-citationFecal microbiota transplantation: current challenges and future landscapes
Yadegar, A., Bar‐Yoseph, H., Monaghan, T. M., Pakpour, S., Severino, A., Kuijper, E. J., Smits, W. K., Terveer, E. M., Neupane, S., Nabavi-Rad, A., et al. (2024) · Clinical Microbiology Reviews · doi:10.1128/cmr.00060-22 · Cited by 379 · see citing works
Self-citationGut microbiome and its role in colorectal cancer
Reberšek, M. (2021) · BMC Cancer · doi:10.1186/s12885-021-09054-2 · Cited by 365 · see citing works
Key determinants of success in fecal microbiota transplantation: From microbiome to clinic
Porcari, S., Benech, N., Valles-Colomer, M., Segata, N., Gasbarrini, A., Cammarota, G., Sokol, H., & Ianiro, G. (2023) · Cell Host & Microbe · doi:10.1016/j.chom.2023.03.020 · Cited by 331 · see citing works
Self-citationPeery, A. F., Kelly, C. R., Kao, D. H., Vaughn, B. P., Lebwohl, B., Singh, S. S., Imdad, A., & Altayar, O. (2024) · Gastroenterology · doi:10.1053/j.gastro.2024.01.008 · Cited by 282 · see citing works
Self-citationThe microbiome in inflammatory bowel diseases: from pathogenesis to therapy
Liu, S., Zhao, W., Lan, P., & Mou, X. (2020) · Protein & Cell · doi:10.1007/s13238-020-00745-3 · Cited by 266 · see citing works
“Some key issues should be followed: FMT indications; donor selection; preparation of faecal material; clinical management and faecal delivery; registries, monitoring of outcomes and ethical issues; basic requirements for implementing an FMT centre (Cammarota et al., 2017, 2019).”
BackgroundZhang, T., Lu, G., Zhao, Z., Liu, Y., Shen, Q., Li, P., Chen, Y., Yin, H., Wang, H., Marcella, C., et al. (2020) · Protein & Cell · doi:10.1007/s13238-019-00684-8 · Cited by 262 · see citing works
“The latest international consensus in 2019 suggested that the minimum quantity of donor stool is 12.5 g for upper gastrointestinal delivery, and 25 g for lower gastrointestinal delivery (Cammarota et al., 2019).”
BackgroundInfluentialBioinspired oral delivery of gut microbiota by self-coating with biofilms
Wang, X., Cao, Z., Zhang, M., Meng, L., Ming, Z., & Liu, J. (2020) · Science Advances · doi:10.1126/sciadv.abb1952 · Cited by 255 · see citing works
“While fecal microbiota transplantation has been successful in prevention and treatment, the implementation has been largely restricted by invasive operation and indeterminate composition, which inevitably lead to low patient compliance as well as gastrointestinal (GI) irritation and potential complication (9, 10).”
BackgroundMarcella, C., Cui, B., Kelly, C. R., Ianiro, G., Cammarota, G., & Zhang, F. (2021) · Alimentary Pharmacology & Therapeutics · doi:10.1111/apt.16148 · Cited by 250 · see citing works
“In the group of patients without mucosal barrier injury, a total of 20 studies involving 555 patients (731 FMT courses) were reported, including FMT indications of IBS (11), constipation (6), obesity (2) and autism (1).”
BackgroundSelf-citationGut Microbiota Metabolism and Interaction with Food Components
Vernocchi, P., CHIERICO, F. D., & Putignani, L. (2020) · International Journal of Molecular Sciences · doi:10.3390/ijms21103688 · Cited by 236 · see citing works
Self-citationVersatility of bacterial outer membrane vesicles in regulating intestinal homeostasis
Wang, X., Lin, S., Wang, L., Cao, Z., Zhang, M., Zhang, Y., Liu, R., & Liu, J. (2023) · Science Advances · doi:10.1126/sciadv.ade5079 · Cited by 220 · see citing works
“Considering the safety issues of clinical application of FMT, the success of Akk OMVs on these treatments spotlighted the potential of using gut microbiota–derived OMVs as an alternative to FMT (58).”
BackgroundPark, J. C., & Im, S. (2020) · Experimental & Molecular Medicine · doi:10.1038/s12276-020-0473-2 · Cited by 217 · see citing works
Fecal microbiota transplantation in human metabolic diseases: From a murky past to a bright future?
Hanssen, N. M. J., de Vos, W. M., & Nieuwdorp, M. (2021) · Cell Metabolism · doi:10.1016/j.cmet.2021.05.005 · Cited by 199 · see citing works
“careful donor selection and screening for infectious diseases is mandated for obvious reasons (Cammarota et al., 2019), the interpretation and comparison between these studies has been hamperedby a large heterogeneity in themethods bywhichmetabolic health and diet of the FMT donor is assessed and via which route the F…”
MethodSelf-citationRegulation, risk and safety of Faecal Microbiota Transplant
Merrick, B., Allen, L., Masirah M Zain, N., Forbes, B., Shawcross, D. L., & Goldenberg, S. D. (2020) · Infection Prevention in Practice · doi:10.1016/j.infpip.2020.100069 · Cited by 171 · see citing works
“FMT is now being proposed by some as a valid treatment option for patients with a first episode of CDI [65] despite current guidelines advising against this [22,24].”
Microbiota-Centered Interventions: The Next Breakthrough in Immuno-Oncology?
Derosa, L., Routy, B., Desilets, A., Daillère, R., Terrisse, S., Kroemer, G., & Zitvogel, L. (2021) · Cancer Discovery · doi:10.1158/2159-8290.cd-21-0236 · Cited by 170 · see citing works
Gut microbiota: A new insight into lung diseases
Ma, P.-J., Wang, M., & Wang, Y. (2022) · Biomedicine & Pharmacotherapy · doi:10.1016/j.biopha.2022.113810 · Cited by 166 · see citing works
Keller, J. J., Ooijevaar, R. E., Hvas, C. L., Terveer, E. M., Lieberknecht-Jouy, S. C., Högenauer, C., Arkkila, P. E. T., Sokol, H., Gridnyev, O., Mégraud, F., et al. (2020) · United European Gastroenterology Journal · doi:10.1177/2050640620967898 · Cited by 163 · see citing works
Self-citationPark, S.-H., Lee, J. H., Shin, J., Kim, J.-S., Cha, B., Lee, S., Kwon, K. S., Shin, Y. W., & Choi, S. H. (2021) · Current Medical Research and Opinion · doi:10.1080/03007995.2021.1957807 · Cited by 157 · see citing works
Faecal microbiota transplantation for Clostridioides difficile: mechanisms and pharmacology
Khoruts, A., Staley, C., & Sadowsky, M. J. (2021) · Nature Reviews Gastroenterology & Hepatology · doi:10.1038/s41575-020-0350-4 · Cited by 155 · see citing works
Reorganisation of Faecal Microbiota Transplant Services During the COVID-19 Pandemic
Ianiro, G., Mullish, B. H., Kelly, C. R., Kassam, Z., Kuijper, E. J., Ng, S. C., Iqbal, T. H., Allegretti, J. R., Bibbò, S., Sokol, H., et al. (2020) · Gut · doi:10.1136/gutjnl-2020-321829 · Cited by 147 · see citing works
Self-citationDevelopment of Gut Microbiota in the First 1000 Days after Birth and Potential Interventions
Pantazi, A. C., Bălașa, A. L., Mihai, C. M., Chisnoiu, T., Lupu, V. V., Kassim, M. A. K., Mihai, L., Frecuș, C. E., Chirila, S. I., Lupu, A., et al. (2023) · Nutrients · doi:10.3390/nu15163647 · Cited by 163 · see citing works
Gheorghe, C. E., Ritz, N. L., Martin, J. A., Wardill, H. R., Cryan, J. F., & Clarke, G. A. (2021) · Gut Microbes · doi:10.1080/19490976.2021.1941711 · Cited by 149 · see citing works
Nanjing consensus on methodology of washed microbiota transplantation
Fecal Microbiota Transplantation-standardization Study Group, & Shi, Q. (2020) · Chinese Medical Journal · doi:10.1097/cm9.0000000000000954 · Cited by 138 · see citing works
Karimi, M., Shirsalimi, N., Hashempour, Z., Omran, H. S., Sedighi, E., Beigi, F., & Mortezazadeh, M. (2024) · Frontiers in Immunology · doi:10.3389/fimmu.2024.1439176 · Cited by 148 · see citing works
“The selection of a donor depends on various factors, including age, body mass index (BMI), genetic factors, general health, lifestyle and dietary habits, microbiome composition, and screening for chronic conditions (32 – 34).”
BackgroundInfluentialXu, L., Zhang, Y., Li, X., Li, C., Hu, H., Hu, J., Liu, M., Yang, Q. Z., Gu, P., Li, J., et al. (2025) · iMeta · doi:10.1002/imt2.270 · Cited by 138 · see citing works
Lopetuso, L. R., Deleu, S., Godny, L., Petito, V., Puca, P., Facciotti, F., Sokol, H., Ianiro, G., Masucci, L., Abreu, M., et al. (2023) · Gut · doi:10.1136/gutjnl-2023-329948 · Cited by 129 · see citing works
Self-citationIaniro, G., Mullish, B. H., Kelly, C. R., Sokol, H., Kassam, Z., Ng, S. C., Fischer, M., Allegretti, J. R., Masucci, L., Zhang, F., et al. (2020) · The Lancet. Gastroenterology & hepatology · doi:10.1016/s2468-1253(20)30082-0 · Cited by 128 · see citing works
Self-citationFecal Microbiota Transplantation: Screening and Selection to Choose the Optimal Donor
Bibbò, S., Settanni, C. R., Porcari, S., Bocchino, E., Ianiro, G., Cammarota, G., & Gasbarrini, A. (2020) · Journal of Clinical Medicine · doi:10.3390/jcm9061757 · Cited by 127 · see citing works
Self-citationTowards a mechanistic understanding of reciprocal drug–microbiome interactions
Zimmermann, M., Patil, K. R., Typas, A., & Maier, L. (2021) · Molecular Systems Biology · doi:10.15252/msb.202010116 · Cited by 122 · see citing works
“Recently, so-called “ stoolbanks ” became more sophisticated in order to promote accessibility to fecal microbiota transplantation in clinical practice (Cammarota et al , 2019 ).”
Ribeiro, C. F. A., Silveira, G. G. D. O. S., Cândido, E. D. S., Cardoso, M. H. E. S., Carvalho, C. M. E., & Franco, O. L. (2020) · ACS Infectious Diseases · doi:10.1021/acsinfecdis.0c00036 · Cited by 121 · see citing works
Targeting gut microbiota for precision medicine: Focusing on the efficacy and toxicity of drugs
Feng, W., Liu, J., Ao, H., Yue, S., & Peng, C. Y. (2020) · Theranostics · doi:10.7150/thno.47289 · Cited by 127 · see citing works
Wang, Y., Zhang, S., Borody, T. J., & Zhang, F. (2022) · Chinese Medical Journal · doi:10.1097/cm9.0000000000002339 · Cited by 113 · see citing works
“However, the recommended protocols varied among different guideline or consensus.([131,132]) The exclusion criteria for screening allogeneic donors can be listed into eight dimensions: age, physiology, pathology, psychology, veracity, time, living environment, and recipients.”
BackgroundInternational consensus statement on microbiome testing in clinical practice
Porcari, S., Mullish, B. H., Asnicar, F., Ng, S. C., Zhao, L., Hansen, R., O’Toole, P. W., Raes, J., Hold, G. L., Putignani, L., et al. (2024) · The Lancet. Gastroenterology & hepatology · doi:10.1016/s2468-1253(24)00311-x · Cited by 119 · see citing works
“9 There is also growing interest in the potential exploitation of the gut microbiome as a tool in clinical practice for several applications, including the diagnosis, prognostication, or risk assessment for particular disorders; the prediction of patient response to a specific therapy; the…”
InfluentialSelf-citationSarbagili Shabat, C., Scaldaferri, F., Zittan, E., Hirsch, A., Mentella, M. C., Musca, T., Cohen, N. A., Ron, Y., Fliss Isakov, N., Pfeffer, J., et al. (2022) · Journal of Crohn s and Colitis · doi:10.1093/ecco-jcc/jjab165 · Cited by 110 · see citing works
Self-citationWargo, J. A. (2020) · Science · doi:10.1126/science.abc3965 · Cited by 110 · see citing works
Fecal Microbiota Transplantation for the Treatment of Inflammatory Bowel Disease: An Update
Tan, P., Li, X., Shen, J., & Feng, Q. (2020) · Frontiers in Pharmacology · doi:10.3389/fphar.2020.574533 · Cited by 111 · see citing works
“The final fecal substance preserved frozen at a temperature of −80°C is considered to have a maximum shelf life of 2 years (Cammarota et al., 2019).”
BackgroundInfluentialCaldeira, L. D. F., Borba, H. H. L., Tonin, F. S., Wiens, A., Fernández-Llimós, F., & Pontarolo, R. (2020) · PLoS ONE · doi:10.1371/journal.pone.0238910 · Cited by 108 · see citing works
“It is observed that the proportion of clinical remission increased over the evaluated years, probably due to improvements in the protocols of FMT, especially concerning more stringent criteria for selection and screening of donors [70].”
BackgroundMuch More Than IL-17A: Cytokines of the IL-17 Family Between Microbiota and Cancer
Brevi, A., Cogrossi, L. L., Grazia, G., Masciovecchio, D., Impellizzieri, D., Lacanfora, L., Grioni, M., & Bellone, M. (2020) · Frontiers in Immunology · doi:10.3389/fimmu.2020.565470 · Cited by 113 · see citing works
Kragsnæs, M. S., Kjeldsen, J., Horn, H. C., Munk, H. L., Pedersen, J. K., Just, S. A., Ahlquist, P., Pedersen, F. M., de Wit, M. P. T., Möller, S., et al. (2021) · Annals of the Rheumatic Diseases · doi:10.1136/annrheumdis-2020-219511 · Cited by 104 · see citing works
Haifer, C., Kelly, C. R., Paramsothy, S., Andresen, D. N., Papanicolas, L. E., McKew, G. L., Borody, T. J., Kamm, M. A., Costello, S. P., Andrews, J. M., et al. (2020) · Gut · doi:10.1136/gutjnl-2019-320260 · Cited by 106 · see citing works
“33 However, the risk management, safety and quality in the production of FMT needs to be addressed and balanced against the potential benefit of FMT. Clinical indications for FMT may also have to be expanded beyond CDI.”
Self-citationLin, H., Guo, Q., Wen, Z., Tan, S., Chen, J., Lin, L., Chen, P., He, J., Wen, J., & Chen, Y. (2021) · Microbial Cell Factories · doi:10.1186/s12934-021-01720-1 · Cited by 102 · see citing works
“Donor The donor used in this study was screened according to the guidelines for FMT donors in 2019 [41].”
MethodThe use of Faecal Microbiota Transplantation (FMT) in Europe: A Europe-wide survey
Baunwall, S. M. D., Terveer, E. M., Dahlerup, J. F., Erikstrup, C., Arkkila, P. E. T., Vehreschild, M. J. G. T., Ianiro, G., Gasbarrini, A., Sokol, H., Kump, P. K., et al. (2021) · The Lancet Regional Health - Europe · doi:10.1016/j.lanepe.2021.100181 · Cited by 100 · see citing works
“International consensus guidelines exist to guide FMT centres [3 (cid:1) 5], and the responses to the current survey indicate the degree to which these guidelines are adhered to.”
BackgroundSelf-citationPiperni, E., Nguyen, L. H., Manghi, P., Kim, H., Pasolli, E., Andreu‐Sánchez, S., Arrè, A., Bermingham, K. M., Blanco‐Míguez, A., Manara, S., et al. (2024) · Cell · doi:10.1016/j.cell.2024.06.018 · Cited by 103 · see citing works
Shiga Toxin–Producing <i>Escherichia coli</i> Transmission via Fecal Microbiota Transplant
Zellmer, C., Sater, M. R. A., Huntley, M. H., Osman, M., Olesen, S. W., & Ramakrishna, B. (2021) · Clinical Infectious Diseases · doi:10.1093/cid/ciaa1486 · Cited by 98 · see citing works
Fecal microbiota transplantation: Emerging applications in autoimmune diseases
Yang, R., Chen, Z., & Cai, J. (2023) · Journal of Autoimmunity · doi:10.1016/j.jaut.2023.103038 · Cited by 97 · see citing works
Hassall, J., Coxon, C. H., Patel, V., Goldenberg, S. D., & Sergaki, C. (2024) · npj Antimicrobials and Resistance · doi:10.1038/s44259-024-00033-8 · Cited by 101 · see citing works
The Next Generation Fecal Microbiota Transplantation: To Transplant Bacteria or Virome
Yu, Y., Wang, W., & Zhang, F. (2023) · Advanced Science · doi:10.1002/advs.202301097 · Cited by 94 · see citing works
Nicco, C., Paule, A., Konturek, P. C., & Edeas, M. A. (2020) · Diseases · doi:10.3390/diseases8020009 · Cited by 87 · see citing works
“To date, safety concerns and acceptability are the main constraints of therapeutic uses of FMT [24].”
BackgroundKao, D., Wong, K., Franz, R., Cochrane, K., Sherriff, K., Chui, L., Lloyd, C., Roach, B., Bai, A. D., Petrof, E. O., et al. (2021) · The Lancet Gastroenterology & Hepatology · doi:10.1016/s2468-1253(21)00007-8 · Cited by 81 · see citing works
Self-citationApplications of human organoids in the personalized treatment for digestive diseases
Wang, Q., Guo, F., Jin, Y., & Ma, Y. (2022) · Signal Transduction and Targeted Therapy · doi:10.1038/s41392-022-01194-6 · Cited by 82 · see citing works
“An important concept in this framework is the need to identify well-defined beneficial traits in the microbiome and validate the impact of beneficial bacterial combinations on individuals.(450,451) Organoids would be good models to test how to determine the role of target microbiota and the effect of target microbiota.”
BackgroundBishop, E. J., & Tiruvoipati, R. (2022) · Journal of Antimicrobial Chemotherapy · doi:10.1093/jac/dkac404 · Cited by 78 · see citing works
Campos-Madueno, E. I., Moradi, M., Eddoubaji, Y., Shahi, F., Moradi, S., Bernasconi, O. J., Moser, A. I., & Endimiani, A. (2023) · European Journal of Clinical Microbiology & Infectious Diseases · doi:10.1007/s10096-023-04548-2 · Cited by 79 · see citing works
Fecal Microbiota Transplantation: The Evolving Risk Landscape
Gupta, S., Mullish, B. H., & Allegretti, J. R. (2021) · The American Journal of Gastroenterology · doi:10.14309/ajg.0000000000001075 · Cited by 76 · see citing works
“However, CDC and Health Canada state that it is not known if EPEC is a pathogen, and data suggest it may be part of a healthy gut microbiome (46,47).”
BackgroundInfluentialSelf-citationThe right bug in the right place: opportunities for bacterial vaginosis treatment
Wu, S., Hugerth, L. W., Schuppe‐Koistinen, I., & Du, J. (2022) · npj Biofilms and Microbiomes · doi:10.1038/s41522-022-00295-y · Cited by 78 · see citing works
Deschamps, C., Fournier, E., Uriot, O., Lajoie, F., Verdier, C., Comtet-Marre, S., Thomas, M., Kapel, N., Cherbuy, C., Alric, M., et al. (2020) · Applied Microbiology and Biotechnology · doi:10.1007/s00253-020-10959-4 · Cited by 76 · see citing works
Ahmed, E., & Hens, K. (2021) · AJOB Neuroscience · doi:10.1080/21507740.2021.1958096 · Cited by 70 · see citing works
“…a scrutinized evaluation of the medical history of candidate stool donors as well as screening for infectious diseases and disorders that are potentially associated with disruption of gut microbiota, including personal history of psychiatric and neurodevelopmental disorders (Cammarota et al. 2019).”
BackgroundWang, Y., Xu, L., Sun, X., Wan, X., Sun, G., Jiang, R., Li, W., Tian, Y., Liu, X., & Kang, X. (2020) · Research in Veterinary Science · doi:10.1016/j.rvsc.2020.01.020 · Cited by 67 · see citing works
Encapsulated Fecal Microbiota Transplantation: Development, Efficacy, and Clinical Application
Halaweish, H., Boatman, S. M., & Staley, C. M. (2022) · Frontiers in Cellular and Infection Microbiology · doi:10.3389/fcimb.2022.826114 · Cited by 66 · see citing works
Jain, N., Umar, T. P., Fahner, A.-F., & Ģībietis, V. (2023) · Gut Microbes · doi:10.1080/19490976.2023.2232137 · Cited by 65 · see citing works
“Furthermore, in the absence of a clear resolution regarding the features of optimal donors and international consensus regarding the use of banked frozen donor material, the logical next step would be the formulation of relevant international guidelines for FMT screening before donation.(36,37)”
BackgroundStool Banking for Fecal Microbiota Transplantation: Methods and Operations at a Large Stool Bank
Chen, J., Zaman, A., Ramakrishna, B., OpenBiome Team, & Olesen, S. W. (2021) · Frontiers in Cellular and Infection Microbiology · doi:10.3389/fcimb.2021.622949 · Cited by 68 · see citing works
Ianiro, G., Bibbò, S., Porcari, S., Settanni, C. R., Giambò, F., Curta, A. R., Quaranta, G., Scaldaferri, F., Masucci, L., Sanguinetti, M., et al. (2021) · Gut Microbes · doi:10.1080/19490976.2021.1994834 · Cited by 64 · see citing works
“Fecal microbiota transplantation (FMT) is an established therapy for recurrent CDI (rCDI),(9,10) as recommended by international guidelines.(11,12) Increasing evidence suggests that FMT is safe and effective in patients with IBD and rCDI, improves disease activity and reduces the need for escalation of IBD therapy.”
MethodSelf-citationRelationship between Gut Microbiota and Allergies in Children: A Literature Review
Pantazi, A. C., Mihai, C. M., Bălașa, A. L., Chisnoiu, T., Lupu, A., Frecuș, C. E., Mihai, L., Ungureanu, A., Kassim, M. A. K., Andrusca, A., et al. (2023) · Nutrients · doi:10.3390/nu15112529 · Cited by 73 · see citing works
“Fecal microbiota transplantation is a method which can normalize the gut microbiota of the affected individuals through replacement of that microbiota with another microecosystem from a healthy individual [80], and it has been proving effective in treating many conditions such as recurrent Clostridium difficile infect…”
MethodFecal microbiota transplantation: Uses, questions, and ethics
Grigoryan, Z., Shen, M. J., Twardus, S. W., Beuttler, M. M., Chen, L. A., & Bateman-House, A. (2020) · Medicine in Microecology · doi:10.1016/j.medmic.2020.100027 · Cited by 61 · see citing works
“difficile, among other pathogenic organisms [62,63].”
Lu, G., Wang, W., Li, P., Wen, Q., Cui, B., & Zhang, F. (2022) · Microbial Biotechnology · doi:10.1111/1751-7915.14074 · Cited by 59 · see citing works
“So far, water, sterile saline, phosphate-buffered saline have been used as a vector solvent of faecal material (Liao and Shollenberger, 2003; Mattila et al., 2012; Cammarota et al., 2017, 2019).”
MethodFuture Modulation of Gut Microbiota: From Eubiotics to FMT, Engineered Bacteria, and Phage Therapy
Airola, C., Severino, A., Porcari, S., Fusco, W. G., Mullish, B. H., Gasbarrini, A., Cammarota, G., Ponziani, F. R., & Ianiro, G. (2023) · Antibiotics · doi:10.3390/antibiotics12050868 · Cited by 63 · see citing works
Self-citationAllogeneic hematopoietic cell transplantation, the microbiome, and graft-versus-host disease
van Lier, Y. F., Vos, J., Blom, B., & Hazenberg, M. D. (2023) · Gut Microbes · doi:10.1080/19490976.2023.2178805 · Cited by 60 · see citing works
“Importantly, transfer of pathogens, including multidrug-resistant bacterial strains(105) and infectious viruses,(106) has been described, emphasizing the importance of careful selection and screening of FMT donors.(107) Finally, not the microbial populations themselves but the metabolites they produce could be repleni…”
BackgroundChallenges and costs of donor screening for fecal microbiota transplantations
Bénard, M. V., de Bruijn, C. M. A., Fenneman, A. C., Wortelboer, K., Zeevenhooven, J., Rethans, B., Herrema, H., van Gool, T., Nieuwdorp, M., Benninga, M. A., et al. (2022) · PLoS ONE · doi:10.1371/journal.pone.0276323 · Cited by 57 · see citing works
“Nevertheless, the most relevant in- and exclusion criteria were similar and our approach is in line with current available screenings protocols [14, 23].”
BackgroundResultSelf-citationFecal microbiota transplantation as a promising treatment option for osteoporosis
Zhang, Y., Cao, M., Li, Y., Zhang, R., Wu, M., Yu, Q., & Rui, Y. (2022) · Journal of Bone and Mineral Metabolism · doi:10.1007/s00774-022-01375-x · Cited by 59 · see citing works
Du, C., Luo, Y., Walsh, S., & Grinspan, A. M. (2021) · Journal of Clinical Gastroenterology · doi:10.1097/mcg.0000000000001495 · Cited by 57 · see citing works
Fecal microbiota transplantation in clinical practice: Present controversies and future prospects
Tian, H., Wang, X., Fang, Z., Li, L., Wu, C., Bi, D., Li, N., Chen, Q., & Qin, H. (2024) · hLife · doi:10.1016/j.hlife.2024.01.006 · Cited by 56 · see citing works
“The second stage builds upon this by incorporating life history screening [12].”
Porcari, S., CICCARESE, C., Heidrich, V., Rondinella, D., Quaranta, G., Severino, A., Arduini, D., Buti, S., Fornarini, G., Primi, F., et al. (2026) · Nature Medicine · doi:10.1038/s41591-025-04189-2 · Cited by 56 · see citing works
“Immediately after this step, they were manufactured as fecal aliquots for colono-scopic FMT and/or as FMT capsules, based on specific needs related to planned treatments, following recommendations by international guidelines 32,40,41 .”
InfluentialSelf-citationFecal microbiota transplantation in non-communicable diseases: Recent advances and protocols
Hamamah, S., Gheorghita, R. E., Lobiuc, A., Sîrbu, I. O., & Covașă, M. (2022) · Frontiers in Medicine · doi:10.3389/fmed.2022.1060581 · Cited by 53 · see citing works
“for the provision of safe and correct treatment (148).”
BackgroundRode, A. A., Chehri, M., Krogsgaard, L. R., Heno, K. K., Svendsen, A. T., Ribberholt, I., Helms, M., Engberg, J., Schønning, K., Tvede, M., et al. (2021) · Alimentary Pharmacology & Therapeutics · doi:10.1111/apt.16309 · Cited by 51 · see citing works
“Any corticosteroid use since last CDI 5 (15) 6 (18) 8 (26)”
BackgroundKarjalainen, E. K., Renkonen‐Sinisalo, L., Satokari, R. M., Mustonen, H. K., Ristimaki, A. P., Arkkila, P. E. T., & Lepistö, A. (2021) · Inflammatory Bowel Diseases · doi:10.1093/ibd/izab001 · Cited by 51 · see citing works
“14,15 Research has also investigated FMT in other disorders with increasing intensity.”
BackgroundSelf-citationTegegne, H. A., & Savidge, T. (2025) · Gut Microbes · doi:10.1080/19490976.2025.2569739 · Cited by 55 · see citing works
“103,104 Although the U.S. Food and Drug Administration (FDA) has begun to issue guidance, achieving global regulatory coherence will require coordinated efforts through international bodies such as the World Health Organization (WHO) and the Organisation for Economic Co-operation and Development…”
Reygner, J., Charrueau, C., Delannoy, J., Mayeur, C., Robert, V., Cuinat, C., Meylheuc, T., Mauras, A., Augustin, J., Nicolis, I., et al. (2020) · Gut Microbes · doi:10.1080/19490976.2020.1759489 · Cited by 51 · see citing works
“Here, we assessed the performance of a new freeze-drying process using non-penetrating cryoprotectants, and compared over time results with those obtained with the corresponding samples stored frozen at −80°C after dilution in glycerol, a penetrating cryoprotective agent at both concentrations (G10 and G80) currently…”
ResultInfluentialVendrik, K. E. W., Terveer, E. M., Kuijper, E. J., Nooij, S., Boeije-Koppenol, E., Sanders, I. M. J. G., van Lingen, E., Verspaget, H. W., Berssenbrugge, E. K. L., Keller, J. J., et al. (2021) · The Lancet Infectious Diseases · doi:10.1016/s1473-3099(20)30473-4 · Cited by 49 · see citing works
Self-citationPorcari, S., Ng, S. C., Zitvogel, L., Sokol, H., Weersma, R. K., Elinav, E., Gasbarrini, A., Cammarota, G., Tilg, H., & Ianiro, G. (2025) · Cell · doi:10.1016/j.cell.2025.04.016 · Cited by 50 · see citing works
Self-citationThe gut microbiota promotes pain in fibromyalgia
Cai, W., Haddad, M., Haddad, R., Kesten, I., Hoffman, T., Laan, R., Westfall, S., Defaye, M., Abdullah, N. S., Wong, C., et al. (2025) · Neuron · doi:10.1016/j.neuron.2025.03.032 · Cited by 59 · see citing works
Mari, A., Baker, F. A., Mahamid, M., Sbeit, W., & Khoury, T. (2020) · Journal of Clinical Medicine · doi:10.3390/jcm9030685 · Cited by 53 · see citing works
“Recent international consensus of stool banking f r FMT hav involved experts from Europe, North America, and Australia wh roposed consensus guideline statements regarding several issues in stool banking, including the selection of donors and screening objectives, collection and processing of stool samples, monitoring…”
BackgroundScaldaferri, F., Ianiro, G., Privitera, G., Lopetuso, L. R., Vetrone, L. M., Petito, V., Pugliese, D., Neri, M., Cammarota, G., Ringel, Y., et al. (2020) · Inflammatory Bowel Diseases · doi:10.1093/ibd/izaa181 · Cited by 47 · see citing works
Self-citationExperimental human hookworm infection: a narrative historical review
Chapman, P. R., Giacomin, P., Loukas, A. C., & McCarthy, J. S. (2021) · PLoS neglected tropical diseases · doi:10.1371/journal.pntd.0009908 · Cited by 47 · see citing works
“These standardised criteria would also be relevant for hookworm faeces donation [77].”
BackgroundHalkjær, S. I., Lo, B. Z. S., Cold, F., Christensen, A. H., Holster, S., König, J., Brummer, R. J., Aroniadis, O. C., Lahtinen, P., Holvoet, T., et al. (2023) · World Journal of Gastroenterology · doi:10.3748/wjg.v29.i20.3185 · Cited by 48 · see citing works
Gossip in the gut: Quorum sensing, a new player in the host-microbiota interactions
Coquant, G., Aguanno, D., Pham, S., Grellier, N., Thenet, S., Carrière, V., Grill, J.-P., & Seksik, P. (2021) · World Journal of Gastroenterology · doi:10.3748/wjg.v27.i42.7247 · Cited by 47 · see citing works
Laube, R., Selinger, C. P., Seow, C. H., Christensen, B., Flanagan, E. K., Kennedy, D. S., Mountifield, R. E., Seeho, S. K. M., Shand, A., Williams, A., et al. (2023) · Gut · doi:10.1136/gutjnl-2022-329304 · Cited by 45 · see citing works
Clostridioides difficile and Gut Microbiota: From Colonization to Infection and Treatment
Spigaglia, P. (2024) · Pathogens · doi:10.3390/pathogens13080646 · Cited by 51 · see citing works
“Internationally, panels of experts are involved in its methodological implementation, the standardization of stool banks, and quality assurance to guarantee accessibility to FMT worldwide [184,185].”
BackgroundPérez-Matute, P., Íñiguez, M., de Toro, M., Recio-Fernández, E., & Oteo, J. A. (2020) · Scientific Reports · doi:10.1038/s41598-020-64961-x · Cited by 42 · see citing works
Innes, A. J., Mullish, B. H., Ghani, R., Szydlo, R., Apperley, J. F., Olavarría, E., Palanicawandar, R., Kanfer, E., Milojković, D., McDonald, J. A. K., et al. (2021) · Frontiers in Cellular and Infection Microbiology · doi:10.3389/fcimb.2021.684659 · Cited by 42 · see citing works
“The FMT used in all procedures had been previously prepared in house anaerobically and stored at -80°C for less than six months, using 10% w/v glycerol as cryopreservative (Mullish et al., 2015; Cammarota et al., 2019).”
MethodSelf-citationDissecting mechanisms of fecal microbiota transplantation efficacy in disease
Andary, C. M., Al, K. F., Chmiel, J. A., Gibbons, S., Daisley, B. A., Parvathy, S. N., Vareki, S. M., Bowdish, D. M. E., Silverman, M., & Burton, J. P. (2024) · Trends in Molecular Medicine · doi:10.1016/j.molmed.2023.12.005 · Cited by 42 · see citing works
Fecal Microbiota Transplantation during and Post-COVID-19 Pandemic
Kazemian, N., Kao, D. H., & Pakpour, S. (2021) · International Journal of Molecular Sciences · doi:10.3390/ijms22063004 · Cited by 41 · see citing works
“The logistics of selecting and screening donors as well as optimizing the efficacy of this treatment are the main constraints of the therapeutic uses of FMT [6].”
BackgroundMethodSelf-citationHow to Apply FMT More Effectively, Conveniently and Flexible – A Comparison of FMT Methods
Varga, A., Kocsis, B., Sipos, D., Kása, P., Vigvári, S., Pál, S., Dembrovszky, F., Farkas, N., & Péterfi, Z. (2021) · Frontiers in Cellular and Infection Microbiology · doi:10.3389/fcimb.2021.657320 · Cited by 42 · see citing works
The emerging potential ofmicrobiome transplantation on human health interventions
Junca, H., Pieper, D. H., & Medina, E. (2022) · Computational and Structural Biotechnology Journal · doi:10.1016/j.csbj.2022.01.009 · Cited by 41 · see citing works
“Blastocystis hominis and Dientamoeba fragilis [88].”
The Evolving Landscape of Fecal Microbial Transplantation
Shao, T., Hsu, R., Hacein-Bey, C., Zhang, W., Gao, L., Kurth, M. J., Zhao, H., Shuai, Z., & Leung, P. S. C. (2023) · Clinical Reviews in Allergy & Immunology · doi:10.1007/s12016-023-08958-0 · Cited by 42 · see citing works
From hype to hope: Considerations in conducting robust microbiome science
McGuinness, A. J., Stinson, L. F., Snelson, M., Loughman, A., Stringer, A. M., Hannan, A. J., Cowan, C. S. M., Jama, H. A., Caparros-Martin, J. A., West, M. L., et al. (2023) · Brain Behavior and Immunity · doi:10.1016/j.bbi.2023.09.022 · Cited by 43 · see citing works
“However, the ongoing development of “ stool banks ” and standardised synthetic microbiomes, alongside regulatory frameworks and guidelines for FMT globally, is promising (Cammarota et al., 2019), and hints towards a future where FMT will be more accessible.”
Garavaglia, B., Vallino, L., Amoruso, A., Pane, M., Ferraresi, A., & Isidoro, C. (2024) · Aspects of Molecular Medicine · doi:10.1016/j.amolm.2024.100056 · Cited by 46 · see citing works
Baunwall, S. M. D., Dahlerup, J. F., Engberg, J., Erikstrup, C., Helms, M., Juel, M. A., Kjeldsen, J., Nielsen, H. L., Nilsson, A. C., Rode, A. A., et al. (2021) · Scandinavian Journal of Gastroenterology · doi:10.1080/00365521.2021.1922749 · Cited by 45 · see citing works
“For one treatment, 50 grams of donor stool is recommended [138].”
BackgroundKenneth, M. J., Tsai, H., Fang, C., Hussain, B., Chiu, Y., & Hsu, B. (2022) · Journal of Advanced Research · doi:10.1016/j.jare.2022.12.015 · Cited by 41 · see citing works
“In FMT, faecal material, including bacteria and natural antibacterial agents, is transferred from a healthy individual to a patient’s intestine as treatment [135], which is possibly to be the most direct means manipulating the gut microbiota [136].”
BackgroundNagakubo, D., & Kaibori, Y. (2023) · Microorganisms · doi:10.3390/microorganisms11092307 · Cited by 69 · see citing works
Nooij, S., Ducarmon, Q. R., Laros, J. F. J., Zwittink, R. D., Norman, J. M., Smits, W. K., Verspaget, H. W., Keller, J. J., Terveer, E. M., & Kuijper, E. J. (2021) · Gastroenterology · doi:10.1053/j.gastro.2021.06.009 · Cited by 40 · see citing works
Self-citation
- Authors
- Cammarota, G., Ianiro, G., Kelly, C. R., Mullish, B. H., Allegretti, J. R., Kassam, Z., Putignani, L., Fischer, M., Keller, J. J., Costello, S. P., Sokol, H., Kump, P., Satokari, R., Kahn, S. A., Kao, D., Arkkila, P., Kuijper, E. J., Vehreschild, M. J. G., Pintus, C., Lopetuso, L., Masucci, L., Scaldaferri, F., Terveer, E. M., Nieuwdorp, M., López-Sanromán, A., Kupcinskas, J., Hart, A., Tilg, H., & Gasbarrini, A.
- Affiliations
- Agostino Gemelli University Polyclinic (IT)
- Brown University (US)
- Philipps University of Marburg (DE)
- Brigham and Women's Hospital (US)
- OpenBiome (US)
- Bambino Gesù Children's Hospital (IT)
- Indiana University Indianapolis (US)
- Leiden University Medical Center (NL)
- Queen Elizabeth Hospital (AU)
- Inserm (FR)
- Medical University of Graz (AT)
- University of Helsinki (FI)
- Boston Children's Hospital (US)
- University of Alberta (CA)
- University Hospital Cologne (DE)
- Tissues and Cells Area, Italian National Transplant Center, Rome, Italy
- Amsterdam UMC Location University of Amsterdam (NL)
- Gastroenterology and Hepatology Department, Hospital Universitario Ramon y Cajal, Madrid, Spain
- Department of Gastroenterology, Institute for Digestive Research, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
- St Mark's Hospital (GB)
- Innsbruck Medical University (AT)
- Corresponding author
- Cammarota, Giovanni
- ORCID
- Cammarota, Giovanni
- Ianiro, Gianluca
- Kelly, Colleen R
- Mullish, Benjamin H
- Allegretti, Jessica R
- Kassam, Zain
- Putignani, Lorenza
- Fischer, Monika
- Keller, Josbert J
- Costello, Samuel Paul
- Sokol, Harry
- Satokari, Reetta
- Kahn, Stacy A
- Kao, Dina
- Arkkila, Perttu
- Kuijper, Ed J
- Vehreschild, Maria J GT
- Lopetuso, Loris
- Masucci, Luca
- Scaldaferri, Franco
- Terveer, E M
- Nieuwdorp, Max
- Hart, Ailsa
- Tilg, Herbert
- Gasbarrini, Antonio
- Venue
- Gut
- Publisher
- BMJ
- Published
- 2019-09-28
- Volume
- 68
- Issue
- 12
- Pages
- 2111-2121
- ISSN
- 0017-5749 (ISSN-L)
- 1468-3288
- PMC
- PMC6872442
- OpenAlex
- W2976599382
- Cited by
- 506
- References
- 109
- Citations by year
- 2026: 74 · 2025: 63 · 2024: 87 · 2023: 61 · 2022: 57 · 2021: 73 · 2020: 86 · 2019: 5
- FWCI
- 42.36
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc
- Locations
- Gut (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Kölner Universitäts PublikationsServer (Universität zu Köln) (publishedVersion)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion, other-oa)
- Pure Amsterdam UMC (submittedVersion, cc-by)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- HAL (submittedVersion)
- Leiden Repository (Leiden University) (submittedVersion)
- Työväentutkimus Vuosikirja (submittedVersion)
- Lithuanian University of Health Sciences (submittedVersion)
- HighWire Press Open Archive (submittedVersion)
- PubliCatt (Università Cattolica del Sacro Cuore) (submittedVersion, other-oa)
- Spiral (Imperial College London) (submittedVersion, cc-by-nc)
- 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, Clostridium difficile infection, donor screening, donor recruitment, safety monitoring
- MeSH terms
- Gastrointestinal Microbiome, Fecal Microbiota Transplantation, Clostridium Infections, Humans, Specimen Handling, Clostridioides difficile, Consensus, Donor Selection
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