Fecal microbiota transplantation for refractory Clostridium difficile colitis in solid organ transplant recipients

Am J Transplant. 2014 Feb;14(2):477-80. doi: 10.1111/ajt.12577. Epub 2014 Jan 16.


Fecal microbiota transplantation (FMT) has been shown to be safe and efficacious in individuals with refractory Clostridium difficile. It has not been widely studied in individuals with immunosuppression due to concerns about infectious complications. We describe two solid organ transplant recipients, one lung and one renal, in this case report that both had resolution of their diarrhea caused by C. difficile after FMT. Both recipients required two FMTs to achieve resolution of their symptoms and neither had infectious complications. Immunosuppressed individuals are at high risk for acquisition of C. difficile and close monitoring for infectious complications after FMT is necessary, but should not preclude its use in patients with refractory disease due to C. difficile. Sequential FMT may be used to achieve cure in these patients with damaged microbiota from antibiotic use and immunosuppression.

Keywords: Clostridium difficile; fecal microbiota transplantation; fecal transplant; lung transplant; renal transplant; solid organ transplant.

Publication types

  • Case Reports
  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Clostridioides difficile / pathogenicity
  • Clostridium Infections / etiology
  • Clostridium Infections / therapy*
  • Colitis / etiology
  • Colitis / therapy*
  • Diarrhea / etiology
  • Diarrhea / therapy
  • Drug Resistance, Multiple, Bacterial*
  • Feces / cytology*
  • Feces / microbiology
  • Female
  • Humans
  • Kidney Transplantation / adverse effects*
  • Lung Transplantation / adverse effects*
  • Microbiota*
  • Prognosis
  • Recurrence
  • Transplant Recipients