Cammarota Giovanni, Ianiro Gianluca, Tilg Herbert, Rajilić-Stojanović Mirjana, Kump Patrizia, Satokari Reetta, Sokol Harry, Arkkila Perttu, Pintus Cristina, Hart Ailsa, Segal Jonathan, Aloi Marina, Masucci Luca, Molinaro Antonio, Scaldaferri Franco, Gasbarrini Giovanni, Lopez-Sanroman Antonio, Link Alexander, de Groot Pieter, de Vos Willem M, Högenauer Christoph, Malfertheiner Peter, Mattila Eero, Milosavljević Tomica, Nieuwdorp Max, Sanguinetti Maurizio, Simren Magnus, Gasbarrini Antonio
Department of Gastroenterological Area, "A. Gemelli" Hospital, Catholic University of the Sacred Heart, Rome, Italy.
Department of Internal Medicine I, Gastroenterology, Endocrinology & Metabolism, Medical University, Innsbruck, Austria.
Gut. 2017 Apr;66(4):569-580. doi: 10.1136/gutjnl-2016-313017. Epub 2017 Jan 13.
Faecal microbiota transplantation (FMT) is an important therapeutic option for infection. Promising findings suggest that FMT may play a role also in the management of other disorders associated with the alteration of gut microbiota. Although the health community is assessing FMT with renewed interest and patients are becoming more aware, there are technical and logistical issues in establishing such a non-standardised treatment into the clinical practice with safety and proper governance. In view of this, an evidence-based recommendation is needed to drive the practical implementation of FMT. In this European Consensus Conference, 28 experts from 10 countries collaborated, in separate working groups and through an evidence-based process, to provide statements on the following key issues: FMT indications; donor selection; preparation of faecal material; clinical management and faecal delivery and basic requirements for implementing an FMT centre. Statements developed by each working group were evaluated and voted by all members, first through an electronic Delphi process, and then in a plenary consensus conference. The recommendations were released according to best available evidence, in order to act as guidance for physicians who plan to implement FMT, aiming at supporting the broad availability of the procedure, discussing other issues relevant to FMT and promoting future clinical research in the area of gut microbiota manipulation. This consensus report strongly recommends the implementation of FMT centres for the treatment of infection as well as traces the guidelines of technicality, regulatory, administrative and laboratory requirements.
粪便微生物群移植（FMT）是治疗感染的一种重要的治疗选择。有前景的研究结果表明，FMT在与肠道微生物群改变相关的其他疾病的管理中可能也发挥作用。尽管医学界对FMT的评估兴趣重新燃起，患者也越来越了解，但将这种非标准化治疗安全且妥善地纳入临床实践存在技术和后勤问题。有鉴于此，需要基于证据的建议来推动FMT的实际应用。在本次欧洲共识会议上，来自10个国家的28位专家在不同的工作组中通过基于证据的流程进行合作，就以下关键问题发表声明：FMT的适应症；供体选择；粪便材料的制备；临床管理和粪便输送以及建立FMT中心的基本要求。每个工作组制定的声明首先通过电子德尔菲法，然后在全体共识会议上由所有成员进行评估和投票。这些建议根据现有最佳证据发布，旨在为计划实施FMT的医生提供指导，支持该治疗方法的广泛应用，讨论与FMT相关的其他问题，并促进肠道微生物群操纵领域的未来临床研究。本共识报告强烈建议设立FMT中心用于治疗感染，并阐述了技术、监管、行政和实验室要求的指导原则。
