Matching between Donors and Ulcerative Colitis Patients Is Important for Long-Term Maintenance after Fecal Microbiota Transplantation

• Published in: Journal of clinical medicine 2020-05, Vol.9 (6), p.1650
• Main Authors: Okahara, Koki, Ishikawa, Dai, Nomura, Kei, Ito, Shoko, Haga, Keiichi, Takahashi, Masahito, Shibuya, Tomoyoshi, Osada, Taro, Nagahara, Akihito
• Format: Article
• Language: English
• Subjects: Antibiotics; Clinical medicine; Colon; Colonoscopy; Cytomegalovirus; Disease; Endoscopy; Feces; Hospitals; Inflammatory bowel disease; Microbiota; Patients; Remission (Medicine)
• ISSN: 2077-0383; 2077-0383
• DOI: 10.3390/jcm9061650

We previously demonstrated that fresh fecal microbiota transplantation (FMT) following triple antibiotic therapy (amoxicillin, fosfomycin, metronidazole (AFM); A-FMT) resulted in effective colonization of Bacteroidetes species, leading to short-term clinical response in ulcerative colitis (UC). Its long-term efficacy and criteria for donor selection are unknown. Here, we analyzed the long-term efficacy of A-FMT compared to AFM monotherapy (mono-AFM). AFM was administered to patients with mild to severe UC for 2 weeks until 2 days before fresh FMT. Clinical response and efficacy maintenance were defined by the decrease and no exacerbation in clinical activity index. The population for intention-to-treat analysis comprised 92 patients (A-FMT, n = 55; mono-AFM, n = 37). Clinical response was observed at 4 weeks post-treatment (A-FMT, 56.3%; mono-AFM, 48.6%). Maintenance rate of responders at 24 months post-treatment was significantly higher with A-FMT than mono-AFM (p = 0.034). Significant differences in maintenance rate according to the age difference between donors and patients were observed. Additionally, sibling FMT had a significantly higher maintenance rate than parent–child FMT. Microbial analysis of patients who achieved long-term maintenance showed that some exhibited similarity to their donors, particularly Bacteroidetes species. Thus, A-FMT exhibited long-term efficacy. Therefore, matching between donors and UC patients may be helpful in effectively planning the FMT regimen.