Ooijevaar R E, van Nood E, Goorhuis A, Terveer E M, van Prehn J, Verspaget H W, van Beurden Y H, Dijkgraaf M G W, Keller J J
Department of Gastroenterology and Hepatology, Amsterdam University Medical Centers, VU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands.
Department of Medical Microbiology and Infection Control, Amsterdam University Medical Centers, VU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands.
Microorganisms. 2021 Mar 6;9(3):548. doi: 10.3390/microorganisms9030548.
Fecal microbiota transplantation (FMT) has become a well-established treatment for recurrent infection (rCDI). While short-term outcomes and adverse events relating to FMT have been well documented, there still is a paucity of data with regard to long-term safety. In this report, we describe the long-term follow-up of the prospective cohort of the first randomized controlled trial of FMT for rCDI, and review the existing literature. A total of 34 patients were treated with FMT for rCDI. Seven patients were still alive after a follow-up of more than 10 years and three patients were lost to follow-up. None of the 34 patients had experienced a new-onset autoimmune, gastrointestinal, or malignant disorder during follow-up. We did not find any deterioration or amelioration of pre-existing medical conditions. Furthermore, no deaths directly attributable to FMT could be identified. These findings are in accordance with the data in available literature. In conclusion, no long-term adverse events or complications directly attributable to FMT were found in our prospective cohort. Review of the available literature does not point to long-term risks associated with FMT in this elderly population, provided that carefully screened fecal suspensions are being used. No firm conclusion on the long-term safety of FMT in younger patients could be drawn.
粪便微生物群移植（FMT）已成为复发性艰难梭菌感染（rCDI）的一种成熟治疗方法。虽然与FMT相关的短期结果和不良事件已有充分记录，但关于长期安全性的数据仍然匮乏。在本报告中，我们描述了rCDI的首次FMT随机对照试验前瞻性队列的长期随访情况，并回顾了现有文献。共有34例患者接受了FMT治疗rCDI。随访超过10年后，7例患者仍存活，3例失访。34例患者在随访期间均未出现新发的自身免疫性、胃肠道或恶性疾病。我们未发现原有疾病有任何恶化或改善。此外，未发现任何直接归因于FMT的死亡病例。这些发现与现有文献中的数据一致。总之，在我们的前瞻性队列中未发现直接归因于FMT的长期不良事件或并发症。对现有文献的回顾表明，在该老年人群中，只要使用经过仔细筛选的粪便悬液，FMT不存在长期风险。对于年轻患者FMT的长期安全性，无法得出确切结论。
