Internal Medicine and Gastroenterology, Day Hospital of Gastroenterology and Intestinal Microbiota Transplantation, Fondazione Policlinico A Gemelli IRCCS, Catholic University of Medicine, Roma, Italy
Internal Medicine and Gastroenterology, Day Hospital of Gastroenterology and Intestinal Microbiota Transplantation, Fondazione Policlinico A Gemelli IRCCS, Roma, Italy.
Gut. 2019 Dec;68(12):2111-2121. doi: 10.1136/gutjnl-2019-319548. Epub 2019 Sep 28.
Although faecal microbiota transplantation (FMT) has a well-established role in the treatment of recurrent infection (CDI), its widespread dissemination is limited by several obstacles, including lack of dedicated centres, difficulties with donor recruitment and complexities related to regulation and safety monitoring. Given the considerable burden of CDI on global healthcare systems, FMT should be widely available to most centres.Stool banks may guarantee reliable, timely and equitable access to FMT for patients and a traceable workflow that ensures safety and quality of procedures. In this consensus project, FMT experts from Europe, North America and Australia gathered and released statements on the following issues related to the stool banking: general principles, objectives and organisation of the stool bank; selection and screening of donors; collection, preparation and storage of faeces; services and clients; registries, monitoring of outcomes and ethical issues; and the evolving role of FMT in clinical practice,Consensus on each statement was achieved through a Delphi process and then in a plenary face-to-face meeting. For each key issue, the best available evidence was assessed, with the aim of providing guidance for the development of stool banks in order to promote accessibility to FMT in clinical practice.
尽管粪便微生物群移植(FMT)在治疗复发性感染(CDI)方面具有既定的作用,但由于缺乏专门的中心、供体招募困难以及与监管和安全监测相关的复杂性等几个障碍,其广泛传播受到限制。鉴于 CDI 对全球医疗保健系统的巨大负担,FMT 应该广泛提供给大多数中心。粪便库可以保证患者能够可靠、及时和公平地获得 FMT,并确保可追溯的工作流程,以确保程序的安全性和质量。在这个共识项目中,来自欧洲、北美和澳大利亚的 FMT 专家汇集并发布了有关粪便库的以下问题的声明:粪便库的一般原则、目标和组织;供体的选择和筛查;粪便的收集、准备和储存;服务和客户;登记处、结果监测和伦理问题;以及 FMT 在临床实践中的不断发展作用。通过 Delphi 流程和随后的面对面全体会议,就每个声明达成了共识。对于每个关键问题,评估了最佳可用证据,旨在为粪便库的发展提供指导,以促进临床实践中 FMT 的可及性。