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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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BackgroundMethodInfluentialOrtiz-Olvera, N. X., Fernández-Figueroa, E. A., Argueta, J., Miranda-Ortíz, H., & Ruíz‐García, E. (2023) · Frontiers in Microbiomes · doi:10.3389/frmbi.2023.1219960 · Cited by 3
Human diseases treatment via enema fecal microbiota transplantation. Methodological recommendations
Drapkina, O. M., Vlassov, V. V., Morozov, V. V., Kiselev, A. R., Shrainer, E. V., Sheptulina, A. F., Yafarova, A. A., Pokrovskaya, M. S., Borisova, A. L., & Efimova, I. A. (2024) · Russian Journal of Preventive Medicine · doi:10.17116/profmed20242706179 · Cited by 2
Cibulková, I., Řehořová, V., Wilhelm, M., Soukupová, H., Hajer, J., Duška, F., Daňková, H., & Cahová, M. (2024) · Journal of Clinical Laboratory Analysis · doi:10.1002/jcla.25105 · Cited by 3
“International consensus offers best practice recommendations [6, 16, 17]; however, guidelines for preparation as well as requirements for the final quality and composition of stool filtrate, especially concerning bacterial viability, are not uniformly defined yet.”
BackgroundMarasco, G., Cannarile, D. C., Cremon, C., Papalia, G., Marangoni, A., Zucchelli, A., Barone, M., Lazzarotto, T., Brigidi, P., Stanghellini, V., et al. (2025) · Peritoneal Dialysis International · doi:10.1177/08968608251316165 · Cited by 2
Wang, C., Li, P., Yu, H., Li, Y., ZHANG, C., Zhang, X., Li, H., Li, T., & Ji, H. (2025) · Animal Feed Science and Technology · doi:10.1016/j.anifeedsci.2025.116341 · Cited by 2
Cao, G., Zhu, H., Liang, S., Cao, W., Liu, R., Li, X., Jiang, Y., & Fang, Y. (2025) · Journal of Functional Foods · doi:10.1016/j.jff.2025.106974 · Cited by 2
Jo, H. G., & Seo, G. S. (2021) · Korean Journal of Gastroenterology · doi:10.4166/kjg.2021.089 · Cited by 2
Dolai, S., Ng, J., Hazan, S., Dawson, V., & Borody, T. J. (2021) · Journal of Experimental Pathology · doi:10.33696/pathology.2.020 · Cited by 2
“In 2019, published consensus statements from an international expert panel proposed a set of best practices in FMT [14], and in late 2020 the identification of possible COVID-19 transmission from FMT further highlighted the need for safety and certainty in donor screening [15].”
BackgroundSalandre, A., Delannoy, J., Goudiaby, M. T. B., Barbut, F., Thomas, M., Waligora‐Dupriet, A., & Kapel, N. (2023) · Microorganisms · doi:10.3390/microorganisms11112753 · Cited by 2
“…then diluted 1:5 at room temperature in aerobic conditions in 10% glycerol, used as a cryoprotectant, and stored at − 80 ◦ C as recommended by the International Consensus Conference on Stool Banking for Fecal Microbiota Transplantation in Clinical Practice [16] and used in clinical studies [12,17].”
MethodHu, Y., Hu, C., Jiang, J., Zhang, J., Li, Y., & Peng, Z. (2023) · Frontiers in Medicine · doi:10.3389/fmed.2023.1333209 · Cited by 2
Editorial: Pharmacological Treatments Affecting Gastro-Intestinal Motility in Man
Scarpellini, E., Ianiro, G., & Tack, J. F. (2022) · Frontiers in Pharmacology · doi:10.3389/fphar.2021.801136 · Cited by 2
“This treatment, now commonly used to treat Clostridium difficile infections, seems to pave the road to its usage in functional GI disorders too (e.g. IBS) (Cammarota et al., 2019).”
BackgroundSelf-citationMullish, B. H., Bak, A., Merrick, B., Quraishi, M. N., Goldenberg, S. D., & Williams, H. R. T. (2024) · Journal of Hospital Infection · doi:10.1016/j.jhin.2024.02.021 · Cited by 2
Self-citationDonor Screening for Fecal Microbiota Transplantation
Lee, H. H., & Cho, Y. (2020) · Korean Journal of Medicine · doi:10.3904/kjm.2020.95.3.181 · Cited by 1
“표되었고, 이 권고안에서는 기증자의 선별 과정에 대한 가이 드라인도 제시하고 있다[26].”
Brenig, A., Broekaert, I. J., Gerner, P., Posovszky, C., Hünseler, C., & Joachim, A. (2023) · International Journal of Colorectal Disease · doi:10.1007/s00384-023-04351-7 · Cited by 1
Infecção por Vírus Monkeypox: Avaliação do Doador e do Candidato ao Transplante de Órgãos Sólidos
Clemente, W. T., Stucchi, R. S. B., Santos, D. W. D. C. L., Abdala, E., Pierrotti, L. C., & Santoro‐Lopes, G. (2023) · Brazilian Journal of Transplantation · doi:10.53855/bjt.v26i1.505_port · Cited by 1
“Gut” to grips with the science of the microbiome – a symposium report
Finnegan, Y. E., Neill, H. R., Prpa, E. J., & Pot, B. (2024) · Gut Microbiome · doi:10.1017/gmb.2024.8 · Cited by 2
Johnson, A. C. B., Mojica, M. C., Indugu, N., & Pitta, D. (2025) · Journal of Dairy Science · doi:10.3168/jds.2025-26820 · Cited by 2
Dinis, L., Pinheiro, H., Póvoa, P. M. S. R., Calhau, C., Pestana, D., & Marques, C. (2025) · Acta Médica Portuguesa · doi:10.20344/amp.22750 · Cited by 1
“54 55-57 Intestinal microbiota banks are centralized facilities that provide ready-to-use donor intestinal microbiota preparations (IMP), minimizing the challenges regarding IMT production, distribution, and application.”
Moser, K., Ballif, A., Pillonel, T., Concu, M., Borbolla, E., Nickel, B., Stampfli, C., Ruf, M., Audry, M., Kapel, N., et al. (2026) · Microorganisms · doi:10.3390/microorganisms14010217 · Cited by 1
“For safety reasons, donors undergo rigorous selection procedures, including multiple clinical and biological screenings, to minimize the risk of transmitting pathogens and potential diseases associated with gut microbiota [6].”
Live biotherapeutics and nutraceuticals: Exploring the differences and synergies
Jyoti, Padhi, S., & Rai, A. K. (2026) · Progress in molecular biology and translational science · doi:10.1016/bs.pmbts.2026.01.031 · Cited by 1
Fecal microbiota transplantation in chronic liver disease: Current and future state of the art
Bloom, P. P., & Khanna, S. (2026) · Hepatology Communications · doi:10.1097/hc9.0000000000000927 · Cited by 1
“[ 69 ] One Chinese program has a rigorous 5-step program (uniquely, they evaluate 16S for dysbiosis) with a 1.7% approval rate for donors, leading to high efficacy and low adverse events.”
InfluentialNutraceuticals and the Microbiota–Gut–Brain Axis: A Pathway for Preventing Cognitive Decline
Castillo-Moral, Á., Toda-Ferran, C., Bulló, M., Teichenné, J., & Escoté, X. (2026) · Nutrition Reviews · doi:10.1093/nutrit/nuag017 · Cited by 1
Decoding the microbiome-immune crosstalk in cancer: from mechanisms to therapeutic translation
Zhao, N., Wu, L., Peng, S., Yang, H., 宋永春, Zhang, Y., & Ding, L. (2026) · Biomarker Research · doi:10.1186/s40364-026-00930-2 · Cited by 2
“Compounding these technical limitations, divergent regulatory frameworks across jurisdictions further impede harmonization [169].”
Yu, L., Wu, M., Leung, T. F., & Zheng, X. (2026) · Clinical Reviews in Allergy & Immunology · doi:10.1007/s12016-026-09174-2 · Cited by 1
The role of the gut microbiome in antibiotic-driven antimicrobial resistance
Joshi, G., Rani, S., Bharti, D., Panda, N., Chavan, P., Mathpal, S., Ramaiah, S., & Anbarasu, A. (2026) · Frontiers in Microbiology · doi:10.3389/fmicb.2026.1856738 · Cited by 3
The gut microbiome and colorectal cancer
Dietz, M. A., Subramanian, S., & Staley, C. M. (2026) · Clinical Microbiology Reviews · doi:10.1128/cmr.00332-25 · Cited by 1
“A healthy microbiome eludes easy definition, and modern FMT donor screenings may include blood tests, requirements for frequent donation, fecal examination, and more (250, 251), making donor identification the most expensive component of FMT procedures (252, 253).”
Alanazi, Y. N. (2026) · Frontiers in Immunology · doi:10.3389/fimmu.2026.1883259 · Cited by 1
Große, K., Haedge, F., Fera, C., Hecker, J., Wienströer, J., Tsakmaklis, A., Fichtner, A., Treichel, N. S., Clavel, T., Wirtz, T. H., et al. (2026) · BMJ Open · doi:10.1136/bmjopen-2026-119299 · Cited by 1
“35 36 Although restoration of a healthy microbiome has been shown to reduce antibiotic resistance genes in the gut, 37 the potential risk of introducing pathogens remains.”
Self-citationZhuang, X., Li, X., Yang, Z., & Dai, X. (2026) · Microorganisms · doi:10.3390/microorganisms14091865 · Cited by 1
Kelly, C. R., & Kahn, S. A. (2020) · The Lancet. Gastroenterology & hepatology · doi:10.1016/s2468-1253(20)30043-1 · Cited by 1
Self-citationPaulina Núñez, F., Quera, R., Constanza Bay, M., & Pamela Thomson, M. (2022) · Gastroenterología y Hepatología (English Edition) · doi:10.1016/j.gastre.2021.05.005 · Cited by 1
Stool donor recruitment – A one-year experience
Aira, A., Rubio-García, E., Fehér, C., González-Suárez, B., Casals‐Pascual, C., & Soriano, À. (2022) · Enfermedades infecciosas y microbiologia clinica (English ed ) · doi:10.1016/j.eimce.2021.01.010 · Cited by 1
Guseinova, R. M., & Shestakova, E. A. (2022) · Obesity and metabolism · doi:10.14341/omet12901 · Cited by 1
Danise, A., Furfaro, F., Gattuso, G., Liberato, N. L., Mandelli, C., Mazzola, G., & Osnaghi, B. (2024) · Italian Journal of Medicine · doi:10.4081/itjm.2024.1666 · Cited by 1
Martini, S., Zaccaria, T., Gasbarrini, A., Cammarota, G., Romagnoli, R., & Ianiro, G. (2024) · Transplant Infectious Disease · doi:10.1111/tid.14248 · Cited by 1
Self-citationEconomic and Chronologic Optimization of Fecal Donors Screening Process
Levy, B., Isakov, N. F., Ziv‐Baran, T., Leshno, M., Maharshak, N., & Werner, L. (2024) · MDM Policy & Practice · doi:10.1177/23814683241254809 · Cited by 1
“7,8 9–11 However, neither the consensus reports nor other articles that describe the screening tests for a stool donor refer to the order of the tests to be performed.”
Background
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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