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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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“FMT, also faces similar challenges, though FMT is highly effective for recurrent Clostridioides dif fi cile infection, the high-end requirement for rigorous donor screening, standardized processing protocols, and long-term safety monitoring is a limitation (Cammarota et al., 2019).”
Wang, S., Zhao, Y., Zhang, N., Fan, S., Li, Z., Yang, Z., Wang, W., Xu, Z., & Liu, F. (2026) · Frontiers in Public Health · doi:10.3389/fpubh.2026.1873106
“This includes extensive examinations of donors’ blood and stool samples to detect transmissible diseases, pathogens, parasites, and other health conditions that could affect the gut microbiota (11).”
Putignani, L., Marsiglia, R., Turco, L., Russo, A., Pane, S., Fusco, A., Lopetuso, L., & Trecarichi, E. M. (2026) · Frontiers in Cellular and Infection Microbiology · doi:10.3389/fcimb.2026.1939690
“The fi rst phase of the process involves a thorough screening procedure to identify a suitable donor who is mostly healthy and unrelated (Cammarota et al., 2019).”
Self-citationSi, J., Wang, P., Li, Z., Hao, J., Wang, J., & Zhang, L. (2026) · Molecular Medicine · doi:10.1186/s10020-026-01616-z
“Donors require rigorous clinical, blood, and stool screening to reduce the risk of transmitting pathogens or other harmful microbiome-associated traits (Cammarota et al. 2019; Rondinella et al. 2024).”
Du, H., Zhang, J., Xie, J., & Chen, X. (2026) · Frontiers in Microbiology · doi:10.3389/fmicb.2026.1778491
“Governance frameworks are essential for microbiome-informed methods; while fecal microbiota transplantation is not a cognitive therapy, its mechanistic application highlights the necessity of standardized donor screening, biobanking, and safety management (Cammarota et al., 2019).”
Hafezi, S., Sharif‐Askari, F. S., Sharif‐Askari, N. S., Eladham, M. W., Zayat, A. S., & Halwani, R. (2026) · Frontiers in Immunology · doi:10.3389/fimmu.2026.1884535
“Donor selection requires comprehensive medical history assessment with rigorous screening for infectious diseases to ensure both safety and ef fi cacy (160).”
Jin, J., Xu, C., & Bao, W. (2026) · Animals · doi:10.3390/ani16172744
柴志波, Wang, M., Zheng, J., & Yu, J. (2026) · Frontiers in Pharmacology · doi:10.3389/fphar.2026.1939732
“FMT should therefore be limited to rigorously governed clinical trials with comprehensive donor screening, antimicrobial-resistance testing, product traceability, and prospective adverse-event surveillance (Cammarota et al., 2019).”
Huang, Q., Huifei, X., Qiaoyun, L., Zhang, Y., Zou, J., Gao, Z., Yang, L., Zeng, H., & Liu, J. (2026) · Frontiers in Oncology · doi:10.3389/fonc.2026.1913974
“In small case series, colonoscopic FMT achieved endoscopic remission in 80% of patients (31), and efferent-limb FMT improved endoscopic scores (32, 64).”
Vijverman, L., Maddalena, T., Delrue, C., & Speeckaert, M. M. (2026) · Biomedicines · doi:10.3390/biomedicines14102143
“Because CKD is accompanied by major changes in microbial composition, decreased biodiversity, impaired SCFA production, and increased PBUT levels, FMT has recently been considered a tool to re-establish microbial balance in the gut and support kidney function [156–158].”
What does the gut microbiome teach us about osteoarthritis development and progression?
Dyson, G., Brawner, C., & Jeffries, M. A. (2026) · Best Practice & Research Clinical Rheumatology · doi:10.1016/j.berh.2026.102202
Li, Y., Yu, W., Liu, R., Xiao, P., Li, X., & Zhang, T. (2026) · Advances in Therapy · doi:10.1007/s12325-026-03797-9
Soveral, L. D. F., Holanda, L. R. D. L., de Assunção, I. B. F., Gomes, L. G., de Souza, I. B., Rodrigues, G. D. S., Vanny, P. D. A., Bruña–Romero, O., Palmeiro, J. K., Scheffer, M. C., et al. (2026) · Frontiers in Antibiotics · doi:10.3389/frabi.2026.1905540
“…including those from the IAG HC-UFMG (Terra et al., 2020), the Netherlands Working Group (Terveer et al., 2020), the International Consensus Conference on FMT (Cammarota et al., 2019), the European FMT Working Group (Cammarota et al., 2017), and the Australian Consensus (Haifer et al., 2020).”
Pinzón, M. A., Betancur, J. F., Bolaño, A. P. S., Garnica, J. A. B., Llano, J. F., & Ramírez, B. (2026) · Case Reports in Infectious Diseases · doi:10.1155/crdi/7694915
Hasanuzzaman, M., Bang, C. S., Lee, J. J., & Gong, E. J. (2026) · Journal of Korean Medical Science · doi:10.3346/jkms.2026.41.e335
“119,120 During the coronavirus disease 2019 (COVID-19) pandemic, the U.S. Food and Drug Administration (FDA) issued additional safety communications recommending enhanced donor screening for SARS-CoV-2 infection together with molecular testing of stool or donor specimens where appropriate.”
Shao, T., Li, M., Li, S., Pu, J., Li, C., & Guo, C. (2026) · Frontiers in Immunology · doi:10.3389/fimmu.2026.1945287
“…FMT programs require protocol-speci fi c governance of donor eligibility, product traceability, processing and storage, lot-level release criteria, and adverse-event surveillance; regulatory requirements remain dependent on the intended use, product classi fi cation, and jurisdiction (155, 158).”
InfluentialCobuccio, L. G., Moser, K., Jacot, D., Kapel, N., Tsaousis, A. D., & Galperine, T. K. (2026) · Clinical Microbiology and Infection · doi:10.1016/j.cmi.2026.09.031
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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