Solid organ transplantation (SOT), an alternative therapy for end-stage diseases, offers increased longevity and better quantity of life. Posttransplant complications such as gastrointestinal symptoms, infection, and graft rejection increase risk with graft failure and death. However, the treatment of abovementioned complications remains unsatisfactory. Gut dysbiosis has been reported in patients with SOT, especially in patients with posttransplant complications. Recipients are more susceptible to gut dysbiosis as long-term use of immunosuppressants, antibiotics and corticosteroids. Restoring gut microbiome may be a promising therapy for posttransplant complications. Washed microbiota transplantation (WMT) is a newly improved methodology of fecal microbiota transplantation based on automatic facilities, washing process and a new delivery routine. In this study, investigators aimed to evaluate the efficacy and safety of WMT for postoperative complications in SOT.
solid organ transplantation recipients;
suffering from gastrointestinal symptoms (e.g. diarrhea, constipation, abdominal pian), infection (e.g. Clostridium difficile) post-transplantation and so on;
is willing to undergo WMT and provide written informed consent.
patients with history of gastrointestinal diseases or homologous pathogen infection pre-transplant;
pregnant or lactating females;
expected survival<1 months;
unable to understand the purpose of the study, communicate effectively with investigators and comply with all study procedures;
Solid organ transplantation recipients receiving WMT will be enrolled.
Cohort
Prospective
Washed Microbiota Transplantation
Other interventionWashed microbiota suspension delivered through mild-gut and lower-gut
Stool frequency and consistency
Stool frequency ≥3 times per day was considered as diarrhea. Higher frequency represents more severe diarrhea. Stool consistency will be evaluated according to the Bristol Stool Form Scale ranging from type 1 - type 7. Type 1 and 2 indicate constipation, Type 3 and type 4 indicate normal defecation, Type 5, 6 and 7 indicate diarrhea.
Gastrointestinal Symptom Rating Scale (GSRS)
GSRS is a 15-item instrument designed to assess the symptoms associated with common GI disorders. The GSRS consists of 5 subscales (reflux, diarrhea, constipation, abdominal pain, and indigestion) producing a mean subscale score ranging from 1 (no discomfort) to 7 (very severe discomfort).
The changes in gut microbiota composition by sequencing faecal metagenome
The changes in gut microbe composition before and after WMT were evaluated by sequencing faecal metagenome.
Quality of life by 36-Item Short Form Health Survey(SF-36)
SF-36 is a 36-item questionnaire to assess the impact of disease on daily life. The SF-36 consists of 8 subscales (vitality, physical functioning, bodily pain, general health perceptions, physical role functioning, emotional role functioning, social role functioning, and mental health) ranging from 0 to 100. Lower scores represent more dysfunction.
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The Second Hospital of Nanjing Medical University
Lead sponsor
The Chinese fmtBank
Collaborator
