Donor Recruitment for Fecal Microbiota Transplantation

• Published in: Inflammatory bowel diseases 2015-07, Vol.21 (7), p.1600-1606
• Main Authors: Paramsothy, Sudarshan, Borody, Thomas J, Lin, Enmoore, Finlayson, Sarah, Walsh, Alissa J, Samuel, Douglas, van den Bogaerde, Johan, Leong, Rupert W L, Connor, Susan, Ng, Watson, Mitchell, Hazel M, Kaakoush, Nadeem, Kamm, Michael A
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Blastocystis hominis; Clostridium difficile; Dientamoeba fragilis; Fecal Microbiota Transplantation - methods; Female; Giardia intestinalis; Hepatitis C virus; Humans; Inflammatory Bowel Diseases - microbiology; Inflammatory Bowel Diseases - therapy; Male; Microbiota; Middle Aged; Norovirus; Treatment Outcome; Young Adult
• ISSN: 1078-0998; 1536-4844
• DOI: 10.1097/MIB.0000000000000405

Increasing demand for fecal microbiota transplantation (FMT) has created a need for stool banks sourced from long-term healthy donors. Here, we describe our experience in recruiting and screening fecal donors. Mailbox, newspaper, and online advertisements were used. Potential donors were required to satisfy a prescreen telephone conversation, pass blood and stool investigations, then undertake a screening interview including medical history, physical examination, and evaluation of donor selection criteria. One hundred sixteen potential donors were prescreened of whom 74 failed-47 declined based on study donation requirements (primarily related to frequency and duration of donations), 13 had medical comorbidities, 6 variant Creutzfeldt-Jakob disease risk factors, 8 for other reasons. Thirty-eight completed stool and blood testing-1 failed blood testing (indeterminate hepatitis C serology), whereas 15 failed stool investigations (5 Dientamoeba fragilis, 5 Blastocystis hominis, 1 B. hominis and D. fragilis, 1 Giardia intestinalis plus D. fragilis, 1 Norovirus plus Clostridium difficile toxin positive, and 2 leucocytes or erythrocytes on stool microscopy). Of the 18 potential donors proceeding to screening interview, 6 were excluded (3 body mass index >30, 1 illicit drug use, 1 uncontrolled anxiety and concerns regarding compliance, 1 irregular bowel movements after new medication commencement). In total, only 12 of 116 (10%) potential donors were enrolled as study donors. Recruitment of fecal donors for FMT is challenging with only a small percentage ultimately serving as donors. Many were unable or unwilling to meet the donor commitment requirements. A surprisingly large proportion of healthy asymptomatic donors failed stool testing, primarily due to gastrointestinal parasites.