FIRST STOOL BANK OF THE NORTH-NORTHEAST REGIONS: IMPACT OF ORAL FECAL MICROBIOTA TRANSPLANT ON GRAFT-VERSUS-HOST DISEASE

Introduction Fecal microbiota transplantation (FMT) has shown promise in several conditions. In this context, graft-versus-host disease (GVHD) following allogeneic hematopoietic stem cell transplantation has gained prominence. Evidence suggests that alterations in the gut microbiota are associated with the occurrence of intestinal-type GVHD. Therefore, FMT could be a promising and feasible treatment option.

Objectives The creation of a stool bank to investigate the impact of oral fecal microbiota transplantation on the treatment of graft-versus-host disease after allogeneic hematopoietic stem cell transplantation.

Method Healthy donors are selected, excluding individuals with infectious diseases transmitted by blood or previous FMT, and those who increase the risk of transmitting multidrug-resistant organisms. These donors undergo interviews, and their laboratory and stool tests are collected. The stool samples are stored in a stool bank developed in the Pharmacology Laboratory at the Federal University of Ceará (UFC). On average, 50 grams of fecal substrate are diluted in a 0.9% sterile saline solution, processed, and stored within 6 to 8 hours. Cryopreservation is a key step in the creation of the stool bank, as it preserves the clinical effect of FMT, prevents material crystallization, and allows on-demand treatment. Capsules are considered promising due to their easy administration, less invasiveness, and absence of the risks associated with invasive procedures. A prospective clinical intervention trial is then conducted, and twenty patients are divided into two groups: one receiving conventional treatment for GVHD and the other receiving FMT. Both groups are followed for 2 years.

Results The importance of a stool bank lies in providing ready-to-use products of high quality, in addition to enabling monitoring of treatment responses, side effects, and long-term outcomes of FMT. It is expected that FMT will be safe and viable for the participating patients, with low incidence of adverse events and the ability to repopulate the gut microbiota, aiding in the recovery of the gastrointestinal tract and maintaining a favorable long-term clinical response while reducing GVHD recurrence.

Conclusion The impact of FMT as a promising and feasible option for intestinal GVHD is best proven when there is a well-structured and monitored stool bank, as the responses become much more reliable and reproducible.

 

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No conflict of interest has been declared by the author(s).

Publication History

Article published online:
25 April 2025