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A (Frozen) Boost For Fecal Transplants To Treat Nasty Bacterium

Bottles of frozen human stool for fecal transplants at the nation's first stool bank, OpenBiome (Gabrielle Emanuel for WBUR)

Bottles of frozen human stool for fecal transplants at the nation’s first stool bank, OpenBiome (Gabrielle Emanuel for WBUR)

By Gabrielle Emanuel

Last month, we reported on the first national stool bank and its struggle to survive. This week, a pilot study, published online in Clinical Infectious Diseases, gives the stool bank a helpful boost.

The study found frozen stool from an unrelated donor to be as effective in treating patients as fresh feces taken from the patient’s family member. It also found that the transplant can be successfully administered through the nose.

Before you stop reading, here’s some background: A stool bank is just like a blood bank, but instead of collecting, testing and distributing blood, it works with fecal matter. The main beneficiaries are patients with recurrent Clostridium difficile (C. diff). C. diff is a nasty bacterium that causes such bad diarrhea it can completely disrupt a person’s life. Over the course of a year, it sickens half a million people and kills about 14,000 people in the U.S.

Luckily, there is a very effective treatment: fecal transplants. This is when you take stool from a healthy donor and put it into the gut of a sick patient; the good bacteria then outfights the C. diff. Studies involving animals and fresh fecal material show that this procedure works 90 percent of the time.

“It’s been remarkably successful and gratifying,” said Dr. Elizabeth Hohmann, an associate professor of medicine and infectious diseases at Massachusetts General Hospital and Harvard Medical School, and the study’s senior author. “There aren’t that many things we do in medicine that are over 90 percent effective.”

Despite such a success rate, many doctors are unwilling to do the procedure. One of the main reasons is that finding and screening donors takes a lot of time and can be expensive.

When Mark Smith, a PhD student at MIT, heard about this he decided to partner with some friends and start a stool bank. The thought was that if they provide prescreened, frozen stool, the procedure would be way easier and, thus, boost its availability. Their stool bank has been fully operational since early October.

But the FDA was more cautious. Continue reading