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Updated: Aug 12, 2026
Fecal Microbiota Transplantation via Colonoscopy for Recurrent C. difficile Infection
Published on: December 8, 2014
Donor program for fecal microbiota transplantation: A 3-year experience of a large-volume Italian stool bank
Gianluca Ianiro1, Serena Porcari1, Stefano Bibbò1
1Digestive Disease Center, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Largo "A. Gemelli", 8, 00168, Rome, Italy.
Background:
Due to the increasing rise of C. difficile infection, stool banks and donor programs have been launched to grant access to fecal microbiota transplantation (FMT). Our aim is to describe characteristics and outcomes of the donor program at our stool bank.
Methods:
Donor candidates underwent a four-step selection process, including a clinical interview, blood and stool testing, a further questionnaire and a direct stool testing the day of each donation. From March 2020, specific changes to this process were introduced to avoid the potential transmission of COVID-19. We evaluated the rate of excluded candidates at each step of the screening, as well as the number of total fecal aliquots provided by qualified donors.
Results:
Overall, 114 donor candidates were evaluated. Seventy-five candidates declined to join the program for logistic or personal issues, three were excluded after the questionnaire and seven for positive stool exams. Finally, 29 (25%) subjects qualified as stool donors, and provided 70 stool samples. Fifteen samples were excluded after direct molecular stool testing. A total of 127 aliquots was finally obtained.
Conclusions:
Donor recruitment for FMT is a challenging process, and only a small rate of candidates are eligible as donors.
Insights
Donor recruitment for fecal microbiota transplantation (FMT) is challenging. This study found only 25% of candidates qualified as donors, highlighting the need for efficient screening processes in stool banks.
Area of Science:
- Microbiology
- Gastroenterology
- Infectious Diseases
Background:
- Rising incidence of Clostridioides difficile infection necessitates fecal microbiota transplantation (FMT).
- Stool banks and donor programs are crucial for providing access to FMT.
- Donor screening is essential for the safety and efficacy of FMT.
Purpose of the Study:
- To characterize the donor selection process at a stool bank.
- To evaluate the outcomes of donor recruitment for FMT.
- To identify challenges and success rates in qualifying stool donors.
Main Methods:
- A four-step donor screening process was implemented, including interviews, blood/stool tests, questionnaires, and direct stool testing.
- Modifications were made to the screening process in March 2020 to prevent COVID-19 transmission.
- Exclusion rates at each screening step and the yield of qualified fecal aliquots were analyzed.
Main Results:
- Out of 114 evaluated candidates, only 29 (25%) qualified as stool donors.
- Significant candidate attrition occurred due to logistical/personal reasons (75) and initial screening (10).
- A total of 127 fecal aliquots were obtained after rigorous molecular testing.
Conclusions:
- Donor recruitment for FMT is a complex and demanding process.
- A low eligibility rate among candidates underscores the challenges in establishing robust donor pools.
- Optimizing donor screening protocols is vital for successful FMT programs.
