Fecal Microbiota Transplant in Pediatric Solid Organ Transplant Recipients.

Autor:	Rodig NM; Division of Nephrology, Boston Children's Hospital, Boston, MA.; Department of Pediatrics, Boston Children's Hospital, Boston, MA., Weatherly M; Division of Gastroenterology, Hepatology, and Nutrition, Boston Children's Hospital, Boston, MA., Kaplan AL; Division of Gastroenterology, Hepatology, and Nutrition, Boston Children's Hospital, Boston, MA., Ballal SA; Department of Pediatrics, Boston Children's Hospital, Boston, MA.; Division of Gastroenterology, Hepatology, and Nutrition, Boston Children's Hospital, Boston, MA., Elisofon SA; Department of Pediatrics, Boston Children's Hospital, Boston, MA.; Division of Gastroenterology, Hepatology, and Nutrition, Boston Children's Hospital, Boston, MA., Daly KP; Department of Pediatrics, Boston Children's Hospital, Boston, MA.; Division of Advanced Cardiac Therapies, Department of Cardiology, Boston Children's Hospital, Boston, MA., Kahn SA; Department of Pediatrics, Boston Children's Hospital, Boston, MA.; Division of Gastroenterology, Hepatology, and Nutrition, Boston Children's Hospital, Boston, MA.
Jazyk:	angličtina
Zdroj:	Transplantation [Transplantation] 2023 Sep 01; Vol. 107 (9), pp. 2073-2077. Date of Electronic Publication: 2023 May 22.
DOI:	10.1097/TP.0000000000004656
Abstrakt:	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. Competing Interests: K.P.D. has served as a consultant for CareDx. N.M.R. serves on a Safety Review Committee for Dicerna Pharmaceuticals. The other authors declare no conflicts of interest. (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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