What’s the future of fecal transplants hold?
If you’re just catching up, this week we had a feature about fecal transplant programs coming online in Central Florida.We also spoke with a family that’s done the transplants twice to treat their son’s recurrent C. Diff infections.
Dr. Federico Laham is medical director of Infectious Diseases and co-chairman of the Infection Prevention and Control Committee for Arnold Palmer Hospital for Children. He’s been performing fecal transplants since 2010. I asked him where he saw stool transplants going in the next few years.
“I think that stool transplants will become more mainstay,” Laham said. “Instead of waiting for somebody to suffer two, three, four relapses of C. Diff, we’re gonna be thinking about this after probably the first relapse.”
Check here to read several studies on fecal transplants.
Currently, Laham said 25 to 30 percent of C. Diff infections don’t respond to antibiotics. More and more, Laham has been turning to stool transplants. But there are issues.
One is regulatory: The U.S. Food and Drug Administration has put stool transplants “in a limbo.” And then there are the practical constraints.
“I think our current methods are very cumbersome and costly,” Laham said. “We should find more effective and easier ways to deliver stool transplants into somebody’s intestines.”
There’s hope on the horizon for that. Dr. Christine Lee in Canada studied whether fresh fecal transplants are just as effective as previously frozen.
Turns out, frozen works just as well.
“The ability to use frozen stool eliminates many of the logistical burdens inherent to [fecal microbiota transplant], because stool collection and processing need not be tied to the procedure date and time,” wrote Dr. Preeti N. Malani about the study. “This study also provides greater support for the practice of using centralized stool banks, which could further remove barriers to FMT by making available to clinicians safe, screened stool that can be shipped and stored frozen and thawed for use as needed.”
I spoke with Dr. Christine Lee, who did the study. She said the efficacy of frozen could make the process more widely available.
But she cautioned: Don’t try this at home.
“It’s important that people don’t do this at home,” Lee said. “A donor needs to be properly screened. We don’t want individuals to contract unwanted pathogens like HIV, Hepatitis.”
