Zou Biao, Liu Sheng-Xuan, Li Xue-Song, He Jia-Yi, Dong Chen, Ruan Meng-Ling, Xu Lei, Bai Tao, Huang Zhi-Hua, Shu Sai-Nan
Pediatric Department, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Front Pediatr. 2022 Oct 11;10:964154. doi: 10.3389/fped.2022.964154. eCollection 2022.
Fecal microbiota transplantation (FMT) is an effective treatment for intestinal and extra-intestinal disorders. Nonetheless, long-term safety and efficacy remain major challenges for FMT applications. To date, few long-term follow-up studies have been published on FMT in children.
Retrospective reviewed the medical charts of 74 patients who underwent 508 FMT courses between August 2014 and July 2019 at our medical center. All the FMT procedures followed uniform standards. Baseline characteristics pre-FMT and follow-up data were collected at 1, 3, 6, 12, 36, 60, and 84 months after FMT. All potential influencing factors for adverse events (AEs) were analyzed and assessed using regression analyses.
A total of 70 (13.7%) short-term AEs occurred in twenty-six patients (35.1%). Most AEs (88.5%) occurred within 2 days post-FMT. A total of 91.4% of the AEs were self-limiting. Ulcerative colitis (UC) and within four times of FMT were associated with a higher rate of AEs ( = 0.028 and = 0.021, respectively). The primary clinical remission rate after FMT was as high as 72.9%. Twenty-five children were followed for more than 5 years after FMT. The clinical remission rates gradually decreased over time after FMT. During follow-up, none of the patients developed autoimmune, metabolic, or rheumatologic disorders or tumor-related diseases. However, nine children developed rhinitis, five developed rhinitis, were underweight, and six developed constipation.
FMT is a safe and effective treatment for dysbiosis in children. The long-term efficacy of FMT for each disease decreased over time. Moreover, multiple FMTs are recommended 3 months post-FMT for recurrent diseases.
粪便微生物群移植（FMT）是治疗肠道和肠道外疾病的有效方法。尽管如此，长期安全性和有效性仍然是FMT应用的主要挑战。迄今为止，关于儿童FMT的长期随访研究发表较少。
回顾性分析2014年8月至2019年7月在我们医疗中心接受508次FMT疗程的74例患者的病历。所有FMT程序均遵循统一标准。在FMT后1、3、6、12、36、60和84个月收集FMT前的基线特征和随访数据。使用回归分析对不良事件（AE）的所有潜在影响因素进行分析和评估。
26例患者（35.1%）共发生70例（13.7%）短期AE。大多数AE（88.5%）发生在FMT后2天内。91.4%的AE为自限性。溃疡性结肠炎（UC）和FMT次数在4次以内与较高的AE发生率相关（分别为 = 0.028和 = 0.021）。FMT后的主要临床缓解率高达72.9%。25名儿童在FMT后随访超过5年。FMT后临床缓解率随时间逐渐下降。随访期间，所有患者均未发生自身免疫、代谢或风湿性疾病或肿瘤相关疾病。然而，9名儿童患鼻炎，5名体重不足，6名出现便秘。
FMT是治疗儿童肠道菌群失调的安全有效方法。FMT对每种疾病的长期疗效随时间下降。此外，对于复发性疾病，建议在FMT后3个月进行多次FMT。
