SETTING UP A FAECAL MICROBIOTA TRANSPLANTATION SERVICE: A QUALITY IMPROVEMENT PROJECT

CL Murphy; J O’ Grady; A Moloney; S Cudmore; SA Zulquernain; F Shanahan

doi:10.1055/s-0040-1704771

Endoscopy, Inhaltsverzeichnis

Endoscopy 2020; 52(S 01): S246
DOI: 10.1055/s-0040-1704771

ESGE Days 2020 ePoster presentations

Thursday, April 23, 2020 09:00 – 17:00 Clinical endoscopic practice ePoster area

SETTING UP A FAECAL MICROBIOTA TRANSPLANTATION SERVICE: A QUALITY IMPROVEMENT PROJECT

Authors

CL Murphy

¹Cork University Hospital Department of Gastroenterology, Department of Gastroenterology, Cork, Ireland

²APC Microbiome Ireland, University College Cork, National University of Ireland, Cork, Ireland
J O’ Grady

¹Cork University Hospital Department of Gastroenterology, Department of Gastroenterology, Cork, Ireland

²APC Microbiome Ireland, University College Cork, National University of Ireland, Cork, Ireland
A Moloney

²APC Microbiome Ireland, University College Cork, National University of Ireland, Cork, Ireland
S Cudmore

²APC Microbiome Ireland, University College Cork, National University of Ireland, Cork, Ireland
SA Zulquernain

¹Cork University Hospital Department of Gastroenterology, Department of Gastroenterology, Cork, Ireland

²APC Microbiome Ireland, University College Cork, National University of Ireland, Cork, Ireland
F Shanahan

¹Cork University Hospital Department of Gastroenterology, Department of Gastroenterology, Cork, Ireland

²APC Microbiome Ireland, University College Cork, National University of Ireland, Cork, Ireland

Abstract

Volltext

Aims Faecal Microbiota Transplantation (FMT) via colonoscopy is approved for use in patients with recurrent C. Difficile infection (rCDI). Rigorous donor screening is required to safeguard recipients from transmission of pathogens. Due to changes in EU legislation use of imported faecal matter for FMT was no longer feasible. To address local clinical FMT need, a QI project was undertaken to set up an FMT donor screening service and stool bank in a tertiary referral centre.

Methods To ensure quality and safety for both recipients and donors, a multidisciplinary team formulated local donor screening consensus guidelines, incorporating published guidelines in the literature. Potential donors undergo extensive faecal and blood testing to rule out presence of pathogens and infectious disease, including multi-drug resistant organisms. Stool delivery and processing steps are completed on the hospital campus on a compassionate basis by APC Microbiome Ireland and are stored in a stool bank on the hospital campus. Patients undergo transplant on site at the time of colonoscopy with close clinical follow up which encourages monitoring of treatment outcomes and long term side effects and safety of treatment.

Results To date 28 FMTs have been performed at our institution at the time of colonoscopy. We have successfully set up and are maintaining an endoscopic FMT service under the hospital governance framework to address on-going local clinical need. There have been no adverse events since commencing the project.

Conclusions The aim of the FMT service is to provide high-quality, appropriately screened faecal samples and FMT donations for treating patients with rCDI at colonoscopy. This project shows that establishing a high-quality, safe clinical service with adequate governance and safeguards is achievable at an individual hospital level.