RT Journal Article
SR Electronic
T1 Healthy donor faecal transplant for corticosteroid non-responsive severe alcoholic hepatitis
JF BMJ Case Reports
FD BMJ Publishing Group Ltd
SP bcr-2017-222310
DO 10.1136/bcr-2017-222310
VO 2017
A1 Philips, Cyriac Abby
A1 Phadke, Nikhil
A1 Ganesan, Karthik
A1 Augustine, Philip
YR 2017
UL http://casereports.bmj.com/content/2017/bcr-2017-222310.abstract
AB Patients with severe alcoholic hepatitis (SAH) have high mortality in the presence of steroid unresponsiveness in the absence of clear treatment recommendations. Liver transplantation is the curative option in such cases but is controversial in the wake of severe infections, post-transplant recidivism and long waiting on deceased donor listing. Animal and human studies have shed light on the beneficial effects of gut microbiota modulation in alcoholic liver disease. We present the first report of faecal microbiota transplantation (FMT) in a steroid non-responder in whom, clinical, biochemical and liver disease severity scores improved post-FMT and demonstrate distinct bacterial population changes pre-FMT and post-FMT. Healthy donor FMT could be safe and efficacious in SAH not responding to corticosteroid treatment, as a bridge to liver transplantation (LT) or in candidates who are unwilling or not ideal for LT for improvement in short-term transplant free survival. Larger controlled studies are required for confirmation.