Guidelines - Stool banking for faecal microbiota transplantation in clinical practice

What is it about?

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 procedure. In this consensus project, FMT experts from Europe, North America and Australia gathered and released statements on stool banking.

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Why is it important?

FMT should be accessible to all patients with CDI based on medical need with no interference from other factors, including site of hospitalisation, type of hospital, or ability to pay. Given that the provision of FMT services is at present unequally distributed throughout certain countries, a stool bank would guarantee the dissemination of FMT worldwide and the accessibility of this potentially lifesaving procedure in an equitable fashion. Stool banks can not only provide reliable, timely and equitable access to FMT for CDI, but also facilitate a standardised, cost-effective and traceable workflow that ensures safety and quality of procedure compared with single FMT centres. The aim of this consensus report is to provide guidance on the general organisation and the criteria required to establish a stool bank.

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