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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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“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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Ultra-Processed Food and Gut Microbiota: Do Additives Affect Eubiosis? A Narrative Review
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“In-vitro work suggests that changes in viability are modest, however, given that the mechanism of action of FMT remains largely unknown, clinical data is paramount to help inform stool banking processes.(5) This study aims to assess the impact of FMT processing time and FMT storage time on clinical effectiveness in CD…”
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“Notably, FMT success is partly dependent on the microbial diversity and composition of the stool donor (25), though the ideal approach to donor selection has yet to be defined (26).”
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Faecal Microbiota Transplantation, Paving the Way to Treat Non-Alcoholic Fatty Liver Disease
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“To date, FMT is indicated in the treatment of recurrent Clostridiodes difficile infection with excellent results and was proposed for the treatment of other chronic gut-related disorders.(42,43) In consideration of issues discussed above that underlined the role of the microbiome in modulating the response to immune m…”
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“procedure of FMT in horses is based on extrapolation from the human literature and expert opinions [4,5].”
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“The preliminary interview and laboratory tests are two crucial phases in the screening of potential donors [156].”
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Skjevling, L. K., Hanssen, H. M., Valle, P. C., Goll, R., Juul, F. E., Arlov, Ø., & Johnsen, P. H. (2023) · BMC Gastroenterology · doi:10.1186/s12876-023-02979-x · Cited by 21
Fecal Microbiota Transplantation: Indications, Methods, and Challenges
Lee, J. Y., Kim, Y., Kim, J., & Kim, J. K. (2024) · The Journal of Microbiology · doi:10.1007/s12275-024-00184-3 · Cited by 23
“As stool banks were created and universal donors became more common, screening methods have been standardized; in 2019, international guidelines for donor screening were published (Cammarota et al., 2019).”
Goloshchapov, O. V., Чухловин, А. Б., Bakin, E. A., Stanevich, O. V., Klementeva, R. V., Щербаков, А. А., Shvetsov, A. N., Suvorova, M. A., Bondarenko, S. N., Kucher, М. A., et al. (2020) · Terapevticheskii arkhiv · doi:10.26442/00403660.2020.07.000773 · Cited by 21
“Оптимальным решением может быть отказ от использования родственного донора, что совпадает с мнением экспертов Международной консенсусной конференции по организации банка для ТФМ [38].”
The gut microbiome: what every gastroenterologist needs to know
Mullish, B. H., Quraishi, M. N., Segal, J. P., Ianiro, G., & Iqbal, T. H. (2020) · Frontline Gastroenterology · doi:10.1136/flgastro-2019-101376 · Cited by 21
“79 However, there are still gaps in knowledge related to FMT for the treatment of recurrent CDI.”
Self-citationGoldsmith, J. R., Tomkovich, S., Aunins, J. G., McGovern, B., Mahoney, J. C., Hasson, B. R., McChalicher, C. W. J., & Ege, D. S. (2024) · Gut Microbes · doi:10.1080/19490976.2024.2402550 · Cited by 22
“8 9–11 However, none of these guidelines include an approach toward managing risk for donor stool-derived products that takes into account differing product compositions, manufacturing processes, delivery modalities, and treatment indication as factors influencing screening recommendations.”
BackgroundSpindelboeck, W., Halwachs, B., Bayer, N., Huber-Kraßnitzer, B., Schulz, E., Uhl, B., Gaksch, L., Hatzl, S., Bachmayr, V., Kleißl, L., et al. (2021) · Therapeutic Advances in Hematology · doi:10.1177/20406207211058333 · Cited by 21
Self-citationIaniro, G., Porcari, S., Bibbò, S., Giambò, F., Quaranta, G., Masucci, L., Sanguinetti, M., Gasbarrini, A., & Cammarota, G. (2021) · Digestive and Liver Disease · doi:10.1016/j.dld.2021.04.009 · Cited by 19
Self-citationGut microbiome and liver diseases
Xu, J., Chen, N., Zhou, L., & Liu, Y. (2024) · Fundamental Research · doi:10.1016/j.fmre.2024.09.007 · Cited by 20
“Nevertheless, addressing the clinical obstacles surrounding FMT, including its clinical application, efficacy, durability, and safety, requires close adherence to international consensus guidelines regulating the quality of donor stool and stool banking [ 103 , 104 ].”
Hartuis, S., Lavergne, R., Nourrisson, C., Verweij, J. J., Désoubeaux, G., Lussac‐Sorton, F., Lemoine, J.-P., Cateau, E., Jeddi, F., Poirier, P., et al. (2022) · Parasite · doi:10.1051/parasite/2022026 · Cited by 19
“Besides the diagnosis of gastrointestinal diseases, this technique also represents an attractive approach for rapid donor stool screening in the context of fecal microbiota transplantation [5].”
Review Article: Gastroenterology and Clostridium difficile Infection: Past, Present, and Future
Kelly, C. R., & Allegretti, J. R. (2023) · Clinical Infectious Diseases · doi:10.1093/cid/ciad644 · Cited by 22
Self-citationCurrent perspectives on fecal microbiota transplantation in inflammatory bowel disease
Singh, A., Midha, V., Chauhan, N. S., & Sood, A. (2024) · Indian Journal of Gastroenterology · doi:10.1007/s12664-023-01516-8 · Cited by 20
“Once a potential donor is identified through this questionnaire, a structured physical and laboratory assessment is carried out [46, 48].”
Sood, A., Singh, A., Mahajan, R., Midha, V., Kaur, K., Singh, D., Bansal, N., & Dharni, K. (2020) · Journal of Crohn s and Colitis · doi:10.1093/ecco-jcc/jjaa163 · Cited by 19
Fecal Microbiota Transplantation for Ulcerative Colitis: An Evolving Therapy
Sood, A., Singh, A., Midha, V., Mahajan, R., Kao, D. H., Rubin, D. T., & Bernstein, C. N. (2020) · Crohn s & Colitis 360 · doi:10.1093/crocol/otaa067 · Cited by 21
Self-citationIaniro, G., Bibbò, S., Masucci, L., Quaranta, G., Porcari, S., Settanni, C. R., Lopetuso, L. R., Fantoni, M., Sanguinetti, M., Gasbarrini, A., et al. (2020) · Digestive and Liver Disease · doi:10.1016/j.dld.2020.09.004 · Cited by 19
“[7] Cammarota G , Ianiro G , Kelly CR , et al.”
BackgroundMethodInfluentialSelf-citationLo, S., Hung, T., Lin, Y.-T., Lee, C.-S., Chen, C., Fang, C., & Lai, P. (2024) · European journal of medical research · doi:10.1186/s40001-024-02046-5 · Cited by 18
Yau, Y. K., Mak, J. W. Y., Lui, N. S. R., Ng, W. Y. R., Cheung, C. Y. K., Li, Y. L. A., Ching, Y. L. J., Chin, M. L., Lau, H. S. L., Chan, K. L. F., et al. (2021) · United European Gastroenterology Journal · doi:10.1002/ueg2.12160 · Cited by 18
“This has also been reported in other stool bank centers.(12,50,51) One possible solution is to recruit donors working in/around the same hospital via mass media and posters (Table 4).”
BackgroundHocking, L., Ianiro, G., Leong, R. W. L., Iqbal, T. H., Kao, D. H., Cabling, M., Stockwell, S., Romanelli, R. J., & Marjanovic, S. (2022) · Alimentary Pharmacology & Therapeutics · doi:10.1111/apt.17309 · Cited by 19
Self-citationvan Lingen, E., Baunwall, S. M. D., Lieberknecht-Jouy, S. C., Benech, N., Ianiro, G., Sokol, H., Gasbarrini, A., Cammarota, G., Eriksen, M. K., Jong, A. E. V. D. M., et al. (2023) · Therapeutic Advances in Gastroenterology · doi:10.1177/17562848231156285 · Cited by 18
Self-citationBachour, S. P., Dalal, R. S., & Allegretti, J. R. (2023) · Therapeutic Advances in Gastroenterology · doi:10.1177/17562848231165581 · Cited by 18
Self-citationPancreatic Diseases and Microbiota: A Literature Review and Future Perspectives
Gesualdo, M., Rizzi, F., Bonetto, S., Rizza, S., Cravero, F., Saracco, G. M., & Angelis, C. G. D. (2020) · Journal of Clinical Medicine · doi:10.3390/jcm9113535 · Cited by 17
“Finally, FMT consists of “the infusion of faecal samples from a healthy donor to the GI tract of a recipient patient, in order to cure a specific disease, improving alteration of gut microbiota” [25].”
BackgroundHan, Y. J., Kim, S., Shin, H., Kim, H. W., & Park, J. D. (2024) · Frontiers in Immunology · doi:10.3389/fimmu.2024.1451356 · Cited by 17
Advances in capsule-based fecal microbiota transplantation: clinical applications and innovations
He, Y., Zhang, Y., Yang, D., Luo, H., & Zhou, Y. (2025) · Journal of Translational Medicine · doi:10.1186/s12967-025-07407-0 · Cited by 18
“…such as age, body mass index (BMI), genetic factors, overall health status, lifestyle and dietary habits, micro-biome composition, and chronic disease screening [142, 143]; there is a lack of unified standards for donor screening; and donors with high colonization efficiency may not be identified.”
Beyond Fecal Microbiota Transplantation: Developing Drugs from the Microbiome
Gerardin, Y., Timberlake, S. C., Allegretti, J. R., Smith, M. B., & Kassam, Z. (2020) · The Journal of Infectious Diseases · doi:10.1093/infdis/jiaa700 · Cited by 17
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Self-citationRondinella, D., Quaranta, G., Rozera, T., D’Argenio, P., Fancello, G., Venturini, I., Guarnaccia, A., Porcari, S., Bibbò, S., Sanguinetti, M., et al. (2024) · Microbes and Infection · doi:10.1016/j.micinf.2024.105341 · Cited by 18
“Current FMT guidelines suggest several approaches to avoid the transmission of pathogens, as they recommend either a quarantine of donated feces or a direct testing with a rapid molecular assay for gut pathogens to be assessed in every stool donation [4,5].”
InfluentialSelf-citationTherapeutic role of gut microbiota in lung injury-related cognitive impairment
Cheng, Y., Hu, G., Deng, L., Zan, Y., & Chen, X. (2025) · Frontiers in Nutrition · doi:10.3389/fnut.2024.1521214 · Cited by 19
Ethical implications of recruiting universal stool donors for faecal microbiota transplantation
Mikail, M., O’Doherty, K. C., Poutanen, S. M., & Hota, S. S. (2019) · The Lancet Infectious Diseases · doi:10.1016/s1473-3099(19)30569-9 · Cited by 17
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“Помимо этого необходимо проводить исследование на наличие Strongyloides stercoralis и других нематод, к примеру, Ascaris lumbricoides, Taenia solium и Taenia hominis, принимая во внимание клинические, социальные и географические особенности доноров [42].”
InfluentialZhu, F., Ke, Y., Luo, Y., Wu, J., Wu, P., Ma, F., & Liu, Y. (2021) · Frontiers in Microbiology · doi:10.3389/fmicb.2021.683234 · Cited by 19
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Boicean, A., Bratu, D. G., Bacila, C. I., Tanasescu, C. A. H., Fleacă, R. S., Mohor, C. I., Comaniciu, A., Băluță, T., Roman, M. D., Chicea, R., et al. (2023) · Pathogens · doi:10.3390/pathogens12060766 · Cited by 16
“Donors were tested for SARS-CoV-2 (by RT-PCR test) [6,8,24].”
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Challenges of Screening Prospective Stool Donors for Fecal Microbiota Transplantation
Dubois, N. E., Read, C. Y., OʼBrien, K., & Ling, K. (2020) · Biological Research For Nursing · doi:10.1177/1099800420941185 · Cited by 16
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Self-citationMicrobiota-gut-brain axis pathogenesis and targeted therapeutics in sleep disorders
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Metadata
- 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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