Fecal Microbiota Transplant in Pediatric Solid Organ Transplant Recipients.
Transplantation
; 107(9): 2073-2077, 2023 09 01.
Article
em En
| MEDLINE
| ID: mdl-37211643
ABSTRACT
BACKGROUND:
Fecal microbiota transplant (FMT) is an effective treatment for recurrent Clostridioides difficile infection (CDI). Safety concerns around FMT are increased in immunocompromised populations, such as solid organ transplant (SOT) recipients. Outcomes among adult SOT recipients suggest FMT is efficacious and safe; however, pediatric SOT data are lacking.METHODS:
We describe the efficacy and safety of FMT among pediatric SOT recipients in a single-center retrospective study from March 2016 to December 2019. Successful FMT was defined as no recurrence of CDI within 2 mo of FMT. We identified 6 SOT recipients ages 4-18 y who received FMT a median of 5.3 y post-SOT.RESULTS:
Success after a single FMT was 83.3%. One liver recipient did not achieve cure after 3 FMTs and remains on low-dose vancomycin. One serious adverse event (SAE) occurred; cecal perforation and bacterial peritonitis occurred following colonoscopic FMT coordinated with intestinal biopsy in a kidney transplant recipient. He achieved full recovery and CDI cure. There were no other SAEs. There were no adverse events related to immunosuppression or transplantation status including bacteremia, cytomegalovirus activation or reactivation, allograft rejection, or allograft loss.CONCLUSIONS:
In this limited series, efficacy of FMT in pediatric SOT is comparable to efficacy in the general pediatric recurrent CDI population. There may be an increased risk of procedure-related SAE in SOT patients and larger cohort studies are needed.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Clostridioides difficile
/
Transplante de Órgãos
/
Infecções por Clostridium
Tipo de estudo:
Observational_studies
/
Risk_factors_studies
Limite:
Adult
/
Child
/
Humans
/
Male
Idioma:
En
Ano de publicação:
2023
Tipo de documento:
Article