During the International Liver Congress, held between April 11 and 15, 2018 in Paris (France), the results of a new study have been presented showing that a single treatment using an optimized and specific form of faecal microbiota transplant ( FMT) produces sustained clinical and cognitive improvements in the long term in patients with liver cirrhosis and hepatic encephalopathy (HE) who had previously participated in a short-term study (presented last year at the same congress that was held in Amsterdam). The original, randomized study, enrolled 20 outpatients with cirrhosis and recurrent HE who received either the traditional treatment or a single EMT enema. The EMT improved daily cognitive function and reduced episodes of HE as well as the number of hospitalizations during the following 5 months compared to those who followed standard therapy.
“In conducting the original study, we primarily wanted to assess whether FMT was safe in patients with recurrent HE compared with standard therapy,” explained Jasmohan Bajaj of Virginia Commonwealth University Jasmohan S. “We identified a single donor from a universal bank that had the highest relative abundance of Lachnospiraceae and Ruminococcaceae, and FMT enemas were prepared using a single stool sample provided by this donor”.
The long-term analysis (one year) showed that one participant in the FMT group had died, while three in the standard therapy group had either died or needed a liver transplant. Among the remaining participants, the FMT demonstrated sustained and significant improvements in cognitive function at one year compared to those who followed conventional treatment.
“This study provides important evidence. The encouraging long-term results of FMT in HE strongly support the need for a more comprehensive and multicenter study of this type of intervention. “