Fecal Microbiota Transplant (FMT)
Fecal Microbiota Transplant (FMT) is a novel therapy for the treatment of persistent or relapsing Clostridium difficile (C. difficile) infections. FMT involves the delivery of specially prepared stool (fecal) material from a healthy donor to a patient recipient. The transplanted fecal matter repopulates the recipient’s gut bacterial microbiome with diverse microorganisms that re-establish a healthy environment and alleviate disease symptoms. In patients with recurrent C. difficile infection who have previously failed to recover following antibiotic therapy, FMT has been shown to be highly effective.
The FMT program at the University of Pittsburgh Medical Center (UPMC), which was founded in 2013, is a joint initiative between the Divisions of Infectious Diseases and Gastroenterology in the Department of Medicine. The primary clinical mission of the FMT program is to provide treatment to patients with recurrent C. difficile infections. Our success rate has been > 90 %, which is similar to cure rates across multiple centers in the United States. In April of 2016, we have launched a Volunteer Stool Bank Program, which is similar to the blood bank concept, and allows our patients to have on demand access to stool “treatment doses” from carefully selected healthy donors.
Who should consider FMT?
- Patients 18 years of age or older who have experienced 3 or more episodes of C. difficile infection despite prolonged antibiotic therapy.
- Patients who experienced a single severe episode of C. difficile which required hospital admission may also be eligible.
What does FMT involve?
- The FMT program offers comprehensive medical consultation in a dedicated FMT/CDIFF Clinic at the UPMC Center for Care of Infectious Diseases.
- Patients have the opportunity to utilize a treatment dose from our Volunteer Stool Bank, or identify their own donor.
- Comprehensive laboratory screening (including testing of the blood and stool samples) is required to ensure an appropriate match with the donor.
- FMT can be delivered by capsules, via colonoscopy/upper endoscopy or by naso-duodenal tube (NDT), based on the patient’s preference.
Is FMT safe?
The Food and Drug Administration (FDA) has classified stool as biological agent and provided regulatory guidance for FMT to ensure patient safety. The primary focus of the FMT program at UPMC is the short- and long-term safety for our patients. This is accomplished through careful and extensive screening of both donors and recipients, and by handling fecal matter as a pharmaceutical substance in a dedicated PA Department of Health-approved FMT Laboratory. The manipulation of fecal material is performed in a biological safety cabinet using steam-sterilized, or single use sterile, equipment and reagents approved for patient care. The utmost care is invested to prevent contamination of the donor stool with other microorganisms, including environmental contamination.
How much does FMT cost?
- Clinic visits and laboratory testing prior to, and following, FMT are covered by most insurance plans.
- If a patient chooses to use a Volunteer Stool Bank treatment dose, they will have a onetime $100 out-of-pocket fee at the time of transplant.
- Depending on the patient’s insurance coverage plan, there may also be additional financial responsibilities related to the FMT delivery method (e.g. colonoscopy, upper endoscopy or NDT placement).
- We highly recommend that patients check with their health insurance about FMT coverage prior to scheduling procedures.
Division of Infectious Diseases
Academic Administrative Office
818 Scaife Hall
3550 Terrace Street
Pittsburgh, PA 15261
Center for Care of Infectious Diseases
Falk Medical Building
3601 Fifth Avenue
Pittsburgh, PA 15213
Patient Appointments: 412-647-7228