Tu1192 Clinical, Epigenetic, and Metagenomic Responses to Serial Fecal Microbiome Transplants in Pediatric Ulcerative Colitis

Adverse events in faecal microbiota transplant: a review of the literature

“…In addition the follow up period was highly variable from about 1 week (100) to 15 years. (112) FMT has been applied beyond the treatment of CDI where its use is well established, to ulcerative colitis (10,83,84,(87)(88)(89)(90)(91)(92)(93)(94)(95)(96)(97)(98)(99) Crohn's disease (92,(100)(101)(102)(103)(104)(105)(106)(107) and mixed IBD. (109) Pioneering application in patients with constipation, (105,112) metabolic syndrome (9) and IBS (105,111) has been reported, raising questions as to the exact pathophysiology of these conditions.…”

“…Excluding the RCT for UC previously discussed, (9) 226 of the 1555 ascertained underwent FMT primarily for inflammatory bowel disease. Amongst these were 159 procedures for ulcerative colitis (83,(87)(88)(89)(90)(91)(92)(93)(94)(95)(96)(97)(98)(99)(100) and 67 for Crohn's. (92,(100)(101)(102)(103)(104)(105)(106)(107) In addition eight patients underwent FMT for pouchitis following restorative proctocolectomy for ulcerative colitis, (108) three for mixed UC/Crohns (109) or IBD unspecified.…”

“…(110) Concomitant CDI was present in 6 patients. (90,93) Publications ranged from four single case reports (99,106,107,110) to series ranging from 3 (97,109) to 62 patients. (89)…”

“…(94,98,109) Training in self-administration of FMT allowed one patient to complete 69 procedures in total, initially daily then weekly. (109) A plethora of other methods of administration combine different routes in largely inconsistent regimens, including 25 cases of initial colonoscopic FMT (90,93,97,105,109) and one case of initial naso-jejunal infusion (93) followed by a variable number of rectal enemas. The remaining 21 were described as 'self-administered faecal enemas in a tapered then maintenance schedule'.…”

New treatments for ulcerative colitis: do we have pediatric data?

“…A further study supported the safety of nasogastric administration, but minimal efficacy signal in four UC patients [21]. One pediatric FMT study in UC, (abstract only), looked at an intensive regimen of colonoscopic transplant supported by frequent enema 'top-up' in three patients, demonstrating the safety of this approach plus weaning of standard immunosuppressant therapy during ongoing FMT treatment [22]. Remission was sustained for 11-16 weeks after discontinuation, suggesting no long-term benefit.…”