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- Title
Sterile Fecal Filtrate from a Healthy Donor Improves Microbial Diversity in Patients with Hepatic Encephalopathy.
- Authors
Gedgaudas, Rolandas; Bajaj, Jasmohan S.; Skieceviciene, Jurgita; Valantiene, Irena; Kiudeliene, Edita; Bang, Corinna; Franke, Andre; Schreiber, Stefan; Kupcinskas, Juozas
- Abstract
Background & Aims: Hepatic encephalopathy (HE) remains one of the most debilitating complications of liver cirrhosis. Changes in gut microbiome composition have been linked to liver diseases and its complications including HE. Recent randomized controlled trials showed fecal microbiota transplantation to be safe and effective in HE treatment. However, transferring unidentified live bacteria could cause various complications, including infections, especially in immunocompromised patients. This study aimed to evaluate the safety and efficacy of sterile fecal filtrate transfer (SFFT) for the modulation of the intestinal microbiome of patients with cirrhosis and HE. Methods: A custom-made air pressure filtration device was used for the sterile fecal filtrate preparation. Seven patients received SFFT from the same healthy donor. Patients were monitored at least 30 days after the procedure. Cognition tests, blood and stool sampling were performed to assess the safety and efficacy of SFFT on HE, liver function, and stool microbiome composition on follow-up days 7 and 30. Results: SFFT was well tolerated and resulted in fluctuations in the microbial composition of study participants: α-diversity increased in 4/7 of the patients, without robust engraftment of donors' microbial composition as assessed by β-diversity analysis. No significant effect on cognition tests or liver function was noted after the procedure. One death occurred three months after the procedure; however, it was not related to the SFFT. Conclusions: Despite the effect on the gut microbiome, we did not observe robust improvement in patients' liver function or HE cognition tests after the procedure.
- Subjects
FECAL microbiota transplantation; HEPATIC encephalopathy; MICROBIAL diversity; COGNITIVE testing; GUT microbiome; AIR pressure
- Publication
Journal of Gastrointestinal & Liver Diseases, 2023, Vol 32, Issue 3, p332
- ISSN
1841-8724
- Publication type
Article
- DOI
10.15403/jgld-4906