Stool banking for fecal microbiota transplantation: methods and operations at a large stool bank

Abstract

Objectives: Fecal microbiota transplantation (FMT) is a recommended therapy for recurrent Clostridioides difficile infection and is being investigated as a potential therapy for dozens of microbiome-mediated indications. Stool banks centralize FMT donor screening and FMT material preparation with the goal of improving the safety, quality, convenience, and accessibility of FMT material. Although there are published consensuses on donor screening guidelines, there are few reports about the implementation of those guidelines in functioning stool banks. Methods: To help inform consensus standards with data gathered from real-world settings and, in turn, to improve patient care, here we describe the general methodology used in 2018 by OpenBiome, a large stool bank, and its outputs in that year. Results: In 2018, the stool bank received 7,536 stool donations from 210 donors, a daily average of 20.6 donations, and processed 4,271 of those donations into FMT preparations. The median time a screened and enrolled stool donor actively donated stool was 5.8 months. The median time between the manufacture of an FMT preparation and its shipment to a hospital or physician was 8.9 months. Half of the stool bank's partner hospitals and physicians ordered an average of 0.75 or fewer FMT preparations per month. Conclusions: Further knowledge sharing should help inform refinements of stool banking guidelines and best practices.

High prevalence of extended‐spectrum beta‐lactamase organisms and the COVID‐19 pandemic impact on donor recruitment for fecal microbiota transplantation in Hong Kong

“…The donor selection criteria in Hong Kong are largely similar to those reported by international societies 12,26–28 on risk assessment for infectious diseases, donors' medical history and medications used. However, there are some differences in the practice in Hong Kong.…”

Rejuvenating the human gut microbiome

“…The first stool bank (OpenBiome) was actually started at Medford (Massachusetts, USA) in 2012 [33]. Since then, many stool banks have opened worldwideincluding the University Hospitals of Paris Centre (2014), AdvancingBio at Mather (California, USA, 2015), Public Health England at the Birmingham laboratory (UK, 2015), the Chinese fmtBank (Nanjing, China, 2015), and The Netherlands Donor Feces Bank (Leiden, The Netherlands, 2016)and many more are planned [34].…”

The Use of Fecal Microbiome Transplant in Treating Human Diseases: Too Early for Poop?

“…Presently, there are non-profit organizations promoting FMT research among clinicians and scientists ( Chen et al, 2020 ; McCune et al, 2020 ; Openbiome, n.d. ). Like a blood bank that collects blood, this organization works like a “poop” bank that collects feces samples from donors around the United States, and to date, they have obtained more than 3.5 tons of stool and shipped stool materials to seven countries.…”