PT  - JOURNAL ARTICLE
AU  - Craig Haifer
AU  - Colleen R Kelly
AU  - Sudarshan Paramsothy
AU  - David Andresen
AU  - Lito E Papanicolas
AU  - Genevieve L McKew
AU  - Thomas J Borody
AU  - Michael Kamm
AU  - Samuel P Costello
AU  - Jane M Andrews
AU  - Jakob Begun
AU  - Hiu Tat Chan
AU  - Susan Connor
AU  - Simon Ghaly
AU  - Paul DR Johnson
AU  - Daniel A Lemberg
AU  - Ramesh Paramsothy
AU  - Andrew Redmond
AU  - Harsha Sheorey
AU  - David van der Poorten
AU  - Rupert W Leong
TI  - Australian consensus statements for the regulation, production and use of faecal microbiota transplantation in clinical practice
AID  - 10.1136/gutjnl-2019-320260
DP  - 2020 May 01
TA  - Gut
PG  - 801--810
VI  - 69
IP  - 5
4099  - http://gut.bmj.com/content/69/5/801.short
4100  - http://gut.bmj.com/content/69/5/801.full
SO  - Gut2020 May 01; 69
AB  - Objective Faecal microbiota transplantation (FMT) has proved to be an extremely effective treatment for recurrent Clostridioides difficile infection, and there is interest in its potential application in other gastrointestinal and systemic diseases. However, the recent death and episode of septicaemia following FMT highlights the need for further appraisal and guidelines on donor evaluation, production standards, treatment facilities and acceptable clinical indications.Design For these consensus statements, a 24-member multidisciplinary working group voted online and then convened in-person, using a modified Delphi approach to formulate and refine a series of recommendations based on best evidence and expert opinion. Invitations to participate were directed to Australian experts, with an international delegate assisting the development. The following issues regarding the use of FMT in clinical practice were addressed: donor selection and screening, clinical indications, requirements of FMT centres and future directions. Evidence was rated using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) system.Results Consensus was reached on 27 statements to provide guidance on best practice in FMT. These include: (1) minimum standards for donor screening with recommended clinical selection criteria, blood and stool testing; (2) accepted routes of administration; (3) clinical indications; (4) minimum standards for FMT production and requirements for treatment facilities acknowledging distinction between single-site centres (eg, hospital-based) and stool banks; and (5) recommendations on future research and product development.Conclusions These FMT consensus statements provide comprehensive recommendations around the production and use of FMT in clinical practice with relevance to clinicians, researchers and policy makers.