Craven Laura J, Nair Parvathy Seema, Tat-Ko Justin, Burton Jeremy P, Silverman Michael S
Department of Microbiology and Immunology, London, Ontario, Canada.
Lawson Health Research Institute, London, Ontario, Canada.
Open Forum Infect Dis. 2017 Nov 6;4(4):ofx243. doi: 10.1093/ofid/ofx243. eCollection 2017 Fall.
Knowledge of the impact of the gut microbiome on conditions other than infection has been rapidly increasing, and the potential usefulness of fecal microbiota transplantation (FMT) in these indications is being explored. The need to exclude donors with an increased risk of these diseases has left uncertainties regarding the cost and feasibility of donor screening. The aim of this study was to compare our experience to other donor-screening programs and report the costs associated with establishing a donor-screening program, for the treatment of metabolic syndrome-related conditions.
Forty-six potential donors (PDs) had their medical histories and physical examinations undertaken by a physician. Blood, stool, and urine were screened for 31 viral, bacterial, fungal, and protozoan agents in addition to biochemical characteristics. The price of advertising, doctor's visits and diagnostic tests were calculated to determine the cost of finding a donor.
Of the PDs screened, 5 of 46 passed the history, examination, blood, stool, and urine tests. The most common reasons for exclusion included a body mass index >25 or the detection of , , or . Four of five eligible donors had subsequent travel or illness that contraindicated donation, so only 1 of 46 PDs was suitable. The total cost for finding a single suitable donor was $15190 US dollars. This screening was performed in Canada, and costs in the United States would be substantially higher.
New potential therapeutic uses for FMT have created a demand for stricter exclusion criteria for donors. This study illustrates that screening many individuals to find a donor and the subsequent associated costs may make central processing and shipment a more reasonable alternative.
肠道微生物群对感染以外疾病影响的相关知识正在迅速增加,粪便微生物群移植(FMT)在这些适应症中的潜在用途也在探索之中。排除这些疾病风险增加的供体的必要性,使得供体筛查的成本和可行性存在不确定性。本研究的目的是将我们的经验与其他供体筛查项目进行比较,并报告建立一个用于治疗代谢综合征相关病症的供体筛查项目的成本。
46名潜在供体(PDs)接受了医生的病史询问和体格检查。除了生化特征外,还对血液、粪便和尿液进行了31种病毒、细菌、真菌和原生动物病原体的筛查。计算广告、医生诊疗和诊断测试的费用,以确定寻找供体的成本。
在接受筛查的PDs中,46人中有5人通过了病史、检查、血液、粪便和尿液检测。排除的最常见原因包括体重指数>25或检测到 、 或 。5名合格供体中有4人随后因旅行或疾病而不宜捐赠,因此46名PDs中只有1人合适。找到一名合适供体的总成本为15190美元。这项筛查在加拿大进行,在美国成本会高得多。
FMT新的潜在治疗用途对供体提出了更严格的排除标准要求。本研究表明,筛查众多个体以寻找供体以及随之产生的相关成本,可能使集中处理和运输成为更合理的选择。