The use of Faecal Microbiota Transplantation (FMT) in Europe: A Europe-wide survey : research paper

Abstract

Background: Faecal microbiota transplantation (FMT) is an emerging treatment modality, but its current clini cal use and organisation are unknown. We aimed to describe the clinical use, conduct, and potential for FMT in Europe. Methods: We invited all hospital-based FMT centres within the European Council member states to answer a web-based questionnaire covering their clinical activities, organisation, and regulation of FMT in 2019. Res ponders were identified from trials registered at clinicaltrials.gov and from the United European Gastroenter ology (UEG) working group for stool banking and FMT. Findings: In 2019, 31 FMT centres from 17 countries reported a total of 1,874 (median 25, quartile 10 64) FMT procedures; 1,077 (57%) with Clostridioides difficile infection (CDI) as indication, 791 (42%) with experi mental indications, and 6 (0 3%) unaccounted for. Adjusted to population size, 0 257 per 100,000 population received FMT for CDI and 0 189 per 100,000 population for experimental indications. With estimated 12,400 (6,100 28,500) annual cases of multiple, recurrent CDI and indication for FMT in Europe, the current Euro pean FMT activity covers approximately 10% of the patients with indication. The participating centres dem onstrated high safety standards and adherence to international consensus guidelines. Formal or informal regulation from health authorities was present at 21 (68%) centres. Interpretation: FMT is a widespread routine treatment for multiple, recurrent CDI and an experimental treat ment. Embedded within hospital settings, FMT centres operate with high standards across Europe to provide safe FMT. A significant gap in FMT coverage suggests the need to raise clinical awareness and increase the FMT activity in Europe by at least 10-fold to meet the true, indicated need.