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Updated: Feb 4, 2026
Murine Fecal Isolation and Microbiota Transplantation
Published on: May 26, 2023
Protocol for Fecal Microbiota Transplantation in Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis
Haiming Fang1, Lian Fu1, Jiajia Wang2
1Department of Gastroenterology and Hepatology, The Second Hospital of Anhui Medical University, Hefei, Anhui Province, China.
Background:
Fecal microbiota transplantation (FMT) is an emerging treatment approach for inflammatory bowel disease (IBD). The donor selection, the separation of fecal bacteria, the frequency of FMT, the way of infusion, the long-term safety, and efficacy are still uncertain.
Aim:
To further study the efficacy and safety and protocol of FMT for IBD.
Methods:
A systematic review and meta-analysis were conducted until February, 2018. Clinical remission was established as the primary outcome.
Results:
A total of 596 paediatric and adult IBD patients were enrolled, and 459 patients received FMT therapy. 28.8% (132/459) patients achieved clinical remission during follow-up. 53% (241/459) patients achieved clinical response. The pooled estimated clinical remission for ulcerative colitis (UC) was 21% (95% CI: 8%-37%) and 30% (95% CI: 11%-52%) for Crohn's disease (CD), both with a risk of heterogeneity; 10% (95% CI: 0%-43%) for paediatric UC; 26% (95% CI: 10%-48%) for adult UC; 45% for paediatric CD (95% CI: 24%-66%); 22% (95% CI: 3%-52%) for adult CD. Meta-analysis of cohort studies showed that moderate-severe IBD patients could achieve more significant remission from FMT than mild-moderate patients (P=0.037). Delivery route has no impact on the efficacy of FMT in UC and CD. Based on current available evidence, a trend was observed towards higher clinical remission rate of frozen stool FMT than that of fresh stool for UC, while there was no significant difference between fresh and frozen FMT for CD. The optimal donor stool for FMT is still uncertain. Meta-analysis of RCTs showed that FMT treatment achieved significantly higher clinical remission rate than placebo for UC (28% versus 9%, P=0.0003).
Conclusion:
FMT is an effective and safe therapy for both paediatric and adult IBD; fresh or frozen donor stool, delivery route, and antibiotic pretreatment or not have no impact on the efficacy of FMT in IBD. FMT might be a potential rescue therapy and even an initial standardized therapy for IBD. However, few data exist on long-term safety and efficacy and further validation is needed.
Insights
Fecal microbiota transplantation (FMT) shows promise for inflammatory bowel disease (IBD). This review found FMT effective and safe for IBD patients, with significant clinical remission rates observed.
Area of Science:
- Gastroenterology
- Microbiome Research
- Immunology
Background:
- Fecal microbiota transplantation (FMT) is an emerging treatment for inflammatory bowel disease (IBD).
- Key aspects like donor selection, bacterial separation, FMT frequency, infusion methods, and long-term safety/efficacy remain under investigation.
Purpose of the Study:
- To evaluate the efficacy and safety of FMT for IBD.
- To analyze optimal FMT protocols for IBD treatment.
Main Methods:
- Systematic review and meta-analysis of studies up to February 2018.
- Primary outcome: clinical remission.
- Inclusion of paediatric and adult IBD patients.
Main Results:
- 459 IBD patients received FMT, with 28.8% achieving clinical remission and 53% showing clinical response.
- Pooled clinical remission rates varied by IBD type and age group (e.g., 21% for UC, 30% for CD).
- FMT showed significantly higher remission rates than placebo in UC (28% vs. 9%, P=0.0003); delivery route and stool preparation (fresh/frozen) did not significantly impact efficacy.
Conclusions:
- FMT is an effective and safe therapy for paediatric and adult IBD.
- Current evidence suggests FMT can be a rescue or initial standardized therapy for IBD.
- Further research is needed to establish long-term safety and efficacy.
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