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Updated: May 3, 2026
Fecal Microbiota Transplantation via Colonoscopy for Recurrent C. difficile Infection
Published on: December 8, 2014
Fecal microbiota transplantation for refractory Clostridium difficile colitis in solid organ transplant recipients
R J Friedman-Moraco1, A K Mehta, G M Lyon
1Division of Infectious Diseases, Emory University, Atlanta, GA.
Abstract:
Fecal microbiota transplantation (FMT) has been shown to be safe and efficacious in individuals with refractory Clostridium difficile. It has not been widely studied in individuals with immunosuppression due to concerns about infectious complications. We describe two solid organ transplant recipients, one lung and one renal, in this case report that both had resolution of their diarrhea caused by C. difficile after FMT. Both recipients required two FMTs to achieve resolution of their symptoms and neither had infectious complications. Immunosuppressed individuals are at high risk for acquisition of C. difficile and close monitoring for infectious complications after FMT is necessary, but should not preclude its use in patients with refractory disease due to C. difficile. Sequential FMT may be used to achieve cure in these patients with damaged microbiota from antibiotic use and immunosuppression.
Insights
Fecal microbiota transplantation (FMT) safely resolved refractory Clostridium difficile in two immunosuppressed solid organ transplant recipients. Sequential FMT treatments were effective without infectious complications, suggesting its potential use in similar high-risk patients.
Area of Science:
- Gastroenterology
- Transplant Surgery
- Infectious Diseases
Background:
- Fecal microbiota transplantation (FMT) is effective for refractory Clostridium difficile infections (CDI).
- Use of FMT in immunosuppressed patients, including solid organ transplant recipients, is limited due to safety concerns regarding infectious complications.
- Immunosuppressed individuals face a high risk of acquiring CDI, often exacerbated by antibiotic use and underlying conditions.
Observation:
- This case report details two solid organ transplant recipients (one lung, one renal) who developed refractory CDI.
- Both patients underwent FMT for their C. difficile infections.
- Close monitoring for potential infectious complications post-FMT was implemented.
Findings:
- Both transplant recipients achieved complete resolution of CDI symptoms after undergoing sequential FMT.
- Two FMT treatments were required for symptom resolution in both cases.
- Neither patient experienced any infectious complications following FMT.
Implications:
- FMT can be a safe and effective treatment option for refractory CDI in immunosuppressed solid organ transplant recipients.
- Concerns about infectious complications should not deter the use of FMT in this vulnerable patient population.
- Sequential FMT may be a viable strategy to restore a healthy gut microbiota in patients with antibiotic-induced dysbiosis and immunosuppression.
