Fecal Microbiota Transplantation in a Toddler After Heart Transplant Was a Safe and Effective Treatment for Recurrent Clostridiodes Difficile Infection: A Case Report

Overview

Journal Pediatr Transplant

Specialty Pediatrics

Date 2019 Oct 17

PMID 31617299

Citations 7

Authors

Joseph A Spinner

Claire E Bocchini

Ruth A Luna

Santosh Thapa

Miriam A Balderas

Susan W Denfield

William J Dreyer

Dorottya Nagy-Szakal

Faith D Ihekweazu

James Versalovic

Tor Savidge

Richard Kellermayer

Affiliations

Soon will be listed here.

Abstract

Pediatric recipients of SOT have a significantly increased risk of Clostridiodes (formerly Clostridium) difficile infection (CDI), which is associated with adverse outcomes after SOT. Alterations to the intestinal microbiota community structure increase the risk of CDI. FMT is a safe and effective treatment for recurrent CDI in immunocompetent children and adults. While there are increasing data that FMT in immunosuppressed patients is safe and effective without increased risk of infection, data regarding safety and efficacy of FMT in children after SOT are limited. To our knowledge, we report the youngest immunocompromised patient to undergo FMT and the third overall case of FMT in a child after HTx. Our patient presented with five episodes of rCDI in 6 months, and 16S rRNA genetic analysis revealed significant loss of overall microbiota community structure and diversity prior to FMT compared with a donor and a healthy, age-matched control. After FMT, marked and prolonged (at least 16 months) shifts in the recipient microbiota community structure and diversity were evident, approaching that of donor and healthy, age-matched control. FMT was well tolerated, restored microbial diversity without any graft or transplant complications, and prevented further rCDI episodes after more than 4 years of follow-up.

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