Challenges and costs of donor screening for fecal microbiota transplantations
<h4>Background</h4> The increasing interest to perform and investigate the efficacy of fecal microbiota transplantation (FMT) has generated an urge for feasible donor screening. We report our experience with stool donor recruitment, screening, follow-up, and associated costs in the conte...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2022-01-01
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| Series: | PLoS ONE |
| Online Access: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9584411/?tool=EBI |
| _version_ | 1828096295036780544 |
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| author | Mèlanie V. Bénard Clara M. A. de Bruijn Aline C. Fenneman Koen Wortelboer Judith Zeevenhoven Bente Rethans Hilde J. Herrema Tom van Gool Max Nieuwdorp Marc A. Benninga Cyriel Y. Ponsioen |
| author_facet | Mèlanie V. Bénard Clara M. A. de Bruijn Aline C. Fenneman Koen Wortelboer Judith Zeevenhoven Bente Rethans Hilde J. Herrema Tom van Gool Max Nieuwdorp Marc A. Benninga Cyriel Y. Ponsioen |
| author_sort | Mèlanie V. Bénard |
| collection | DOAJ |
| description | <h4>Background</h4> The increasing interest to perform and investigate the efficacy of fecal microbiota transplantation (FMT) has generated an urge for feasible donor screening. We report our experience with stool donor recruitment, screening, follow-up, and associated costs in the context of clinical FMT trials. <h4>Methods</h4> Potential stool donors, aged between 18−65 years, underwent a stepwise screening process starting with an extensive questionnaire followed by feces and blood investigations. When eligible, donors were rescreened for MDROs and SARS-CoV-2 every 60-days, and full rescreening every 4−6 months. The costs to find and retain a stool donor were calculated. <h4>Results</h4> From January 2018 to August 2021, 393 potential donors underwent prescreening, of which 202 (51.4%) did not proceed primarily due to loss to follow-up, medication use, or logistic reasons (e.g. COVID-19 measures). 191 potential donors filled in the questionnaire, of which 43 (22.5%) were excluded. The remaining 148 candidates underwent parasitology screening: 91 (61.5%) were excluded, mostly due to Dientamoeba fragilis and/or high amounts of Blastocystis spp. After additional feces investigations 18/57 (31.6%) potential donors were excluded (mainly for presence of Helicobacter Pylori and ESBL-producing organisms). One donor failed serum testing. Overall, 38 out of 393 (10%) potential donors were enrolled. The median participation time of active stool donors was 13 months. To recruit 38 stool donors, €64.112 was spent. <h4>Conclusion</h4> Recruitment of stool donors for FMT is challenging. In our Dutch cohort, failed eligibility of potential donors was often caused by the presence of the protozoa Dientamoeba fragilis and Blastocystis spp.. The exclusion of potential donors that carry these protozoa, especially Blastocystis spp., is questionable and deserves reconsideration. High-quality donor screening is associated with substantial costs. |
| first_indexed | 2024-04-11T07:28:08Z |
| format | Article |
| id | doaj.art-f026cd73b3f4456e965217c252735e6e |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-04-11T07:28:08Z |
| publishDate | 2022-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-f026cd73b3f4456e965217c252735e6e2022-12-22T04:37:01ZengPublic Library of Science (PLoS)PLoS ONE1932-62032022-01-011710Challenges and costs of donor screening for fecal microbiota transplantationsMèlanie V. BénardClara M. A. de BruijnAline C. FennemanKoen WortelboerJudith ZeevenhovenBente RethansHilde J. HerremaTom van GoolMax NieuwdorpMarc A. BenningaCyriel Y. Ponsioen<h4>Background</h4> The increasing interest to perform and investigate the efficacy of fecal microbiota transplantation (FMT) has generated an urge for feasible donor screening. We report our experience with stool donor recruitment, screening, follow-up, and associated costs in the context of clinical FMT trials. <h4>Methods</h4> Potential stool donors, aged between 18−65 years, underwent a stepwise screening process starting with an extensive questionnaire followed by feces and blood investigations. When eligible, donors were rescreened for MDROs and SARS-CoV-2 every 60-days, and full rescreening every 4−6 months. The costs to find and retain a stool donor were calculated. <h4>Results</h4> From January 2018 to August 2021, 393 potential donors underwent prescreening, of which 202 (51.4%) did not proceed primarily due to loss to follow-up, medication use, or logistic reasons (e.g. COVID-19 measures). 191 potential donors filled in the questionnaire, of which 43 (22.5%) were excluded. The remaining 148 candidates underwent parasitology screening: 91 (61.5%) were excluded, mostly due to Dientamoeba fragilis and/or high amounts of Blastocystis spp. After additional feces investigations 18/57 (31.6%) potential donors were excluded (mainly for presence of Helicobacter Pylori and ESBL-producing organisms). One donor failed serum testing. Overall, 38 out of 393 (10%) potential donors were enrolled. The median participation time of active stool donors was 13 months. To recruit 38 stool donors, €64.112 was spent. <h4>Conclusion</h4> Recruitment of stool donors for FMT is challenging. In our Dutch cohort, failed eligibility of potential donors was often caused by the presence of the protozoa Dientamoeba fragilis and Blastocystis spp.. The exclusion of potential donors that carry these protozoa, especially Blastocystis spp., is questionable and deserves reconsideration. High-quality donor screening is associated with substantial costs.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9584411/?tool=EBI |
| spellingShingle | Mèlanie V. Bénard Clara M. A. de Bruijn Aline C. Fenneman Koen Wortelboer Judith Zeevenhoven Bente Rethans Hilde J. Herrema Tom van Gool Max Nieuwdorp Marc A. Benninga Cyriel Y. Ponsioen Challenges and costs of donor screening for fecal microbiota transplantations PLoS ONE |
| title | Challenges and costs of donor screening for fecal microbiota transplantations |
| title_full | Challenges and costs of donor screening for fecal microbiota transplantations |
| title_fullStr | Challenges and costs of donor screening for fecal microbiota transplantations |
| title_full_unstemmed | Challenges and costs of donor screening for fecal microbiota transplantations |
| title_short | Challenges and costs of donor screening for fecal microbiota transplantations |
| title_sort | challenges and costs of donor screening for fecal microbiota transplantations |
| url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9584411/?tool=EBI |
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