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Updated: Jan 18, 2026
Fecal Microbiota Transplantation via Colonoscopy for Recurrent C. difficile Infection
Published on: December 8, 2014
International consensus conference on stool banking for faecal microbiota transplantation in clinical practice
Giovanni Cammarota1, Gianluca Ianiro2, Colleen R Kelly3
1Internal Medicine and Gastroenterology, Day Hospital of Gastroenterology and Intestinal Microbiota Transplantation, Fondazione Policlinico A Gemelli IRCCS, Catholic University of Medicine, Roma, Italy giovanni.cammarota@unicatt.it.
Abstract:
Although faecal microbiota transplantation (FMT) has a well-established role in the treatment of recurrent Clostridioides difficile infection (CDI), its widespread dissemination is limited by several obstacles, including lack of dedicated centres, difficulties with donor recruitment and complexities related to regulation and safety monitoring. Given the considerable burden of CDI on global healthcare systems, FMT should be widely available to most centres.Stool banks may guarantee reliable, timely and equitable access to FMT for patients and a traceable workflow that ensures safety and quality of procedures. In this consensus project, FMT experts from Europe, North America and Australia gathered and released statements on the following issues related to the stool banking: general principles, objectives and organisation of the stool bank; selection and screening of donors; collection, preparation and storage of faeces; services and clients; registries, monitoring of outcomes and ethical issues; and the evolving role of FMT in clinical practice,Consensus on each statement was achieved through a Delphi process and then in a plenary face-to-face meeting. For each key issue, the best available evidence was assessed, with the aim of providing guidance for the development of stool banks in order to promote accessibility to FMT in clinical practice.
Insights
Establishing stool banks is crucial for increasing access to faecal microbiota transplantation (FMT) for recurrent Clostridioides difficile infection (CDI). This consensus provides guidance on stool banking to ensure safe and equitable FMT delivery.
Area of Science:
- Gastroenterology
- Microbiology
- Public Health
Background:
- Recurrent Clostridioides difficile infection (CDI) poses a significant healthcare burden.
- Faecal microbiota transplantation (FMT) is effective for recurrent CDI but faces accessibility challenges.
- Obstacles include lack of centers, donor recruitment issues, and regulatory complexities.
Purpose of the Study:
- To provide guidance for establishing stool banks to improve FMT accessibility.
- To address key issues in stool banking for safe and equitable FMT provision.
- To facilitate the widespread adoption of FMT in clinical practice.
Main Methods:
- A consensus project involving FMT experts from Europe, North America, and Australia.
- Statements developed on stool banking principles, donor selection, sample handling, services, registries, and ethics.
- Consensus achieved through a Delphi process and a face-to-face meeting.
- Assessment of the best available evidence for each issue.
Main Results:
- Consensus statements were generated on critical aspects of stool bank operations.
- Guidance covers donor screening, faecal collection, preparation, storage, and outcome monitoring.
- Recommendations aim to ensure the safety, quality, and traceability of FMT procedures.
Conclusions:
- Stool banks are essential for reliable, timely, and equitable access to FMT.
- Standardized stool banking practices are necessary to overcome current dissemination barriers.
- Implementing these guidelines will promote broader FMT availability for recurrent CDI treatment.
