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The use of Faecal Microbiota Transplantation (FMT) in Europe: A Europe-wide survey
Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark.
Department of Medical Microbiology, Leiden University Medical Center, Leiden, the Netherlands; Netherlands Donor Feces Bank, Leiden University Medical Center, Leiden, the Netherlands.
Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark.
Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark.
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2021 (English)In: The Lancet Regional Health: Europe, E-ISSN 2666-7762, Vol. 9, article id 100181Article in journal (Refereed) Published
Abstract [en]

Background: Faecal microbiota transplantation (FMT) is an emerging treatment modality, but its current clinical use and organisation are unknown. We aimed to describe the clinical use, conduct, and potential for FMT in Europe.

Methods: We invited all hospital-based FMT centres within the European Council member states to answer a web-based questionnaire covering their clinical activities, organisation, and regulation of FMT in 2019. Responders were identified from trials registered at clinicaltrials.gov and from the United European Gastroenterology (UEG) working group for stool banking and FMT.

Findings: In 2019, 31 FMT centres from 17 countries reported a total of 1,874 (median 25, quartile 10-64) FMT procedures; 1,077 (57%) with Clostridioides difficile infection (CDI) as indication, 791 (42%) with experimental indications, and 6 (0•3%) unaccounted for. Adjusted to population size, 0•257 per 100,000 population received FMT for CDI and 0•189 per 100,000 population for experimental indications. With estimated 12,400 (6,100-28,500) annual cases of multiple, recurrent CDI and indication for FMT in Europe, the current European FMT activity covers approximately 10% of the patients with indication. The participating centres demonstrated high safety standards and adherence to international consensus guidelines. Formal or informal regulation from health authorities was present at 21 (68%) centres.

Interpretation: FMT is a widespread routine treatment for multiple, recurrent CDI and an experimental treatment. Embedded within hospital settings, FMT centres operate with high standards across Europe to provide safe FMT. A significant gap in FMT coverage suggests the need to raise clinical awareness and increase the FMT activity in Europe by at least 10-fold to meet the true, indicated need.

Funding: NordForsk under the Nordic Council and Innovation Fund Denmark (j.no. 8056-00006B).

Place, publisher, year, edition, pages
Elsevier, 2021. Vol. 9, article id 100181
Keywords [en]
Abbreviations: CDI, Clostridioides difficile infection, Clostridioides difficile, ECDC, European Centre for Disease Prevention and Control, FMT, FMT, Faecal microbiota transplantation, Faecal microbiota transplantation, IQR, Interquartile range, REDCap, Research Data Capture software, SARS-CoV-2, Severe acute respiratory syndrome coronavirus 2, Stool banking, UEG, United Gastroenterology European
National Category
Gastroenterology and Hepatology
Identifiers
URN: urn:nbn:se:oru:diva-95184DOI: 10.1016/j.lanepe.2021.100181ISI: 000709710400016PubMedID: 34693388Scopus ID: 2-s2.0-85111661064OAI: oai:DiVA.org:oru-95184DiVA, id: diva2:1607178
Available from: 2021-10-29 Created: 2021-10-29 Last updated: 2023-12-08Bibliographically approved

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