A different kind of transplant

When all else fails, (and make no mistake, all else is failing), comes the time to think outside the box. Some might argue that the time to think outside the box should come before all else fails, and they are probably correct in that, but that’s another argument.

We are slowly, surely, insidiously returning to a pre-antibiotic age. The antibiotics that we have are becoming less and less effective against common infections and consequently, those common infections are starting to kill us again. One such infection is Clostidium difficile (so “difficile” in fact, that we microbiologists even disagree on how to pronounce it, so it’s “C.diff” to its friends) – a gastrointestinal bug that gives you horrendous – and now incurable – diarrhoea. This bug kills 14,000 Americans each year, and lengthens the hospital stays of hundreds of thousands of others.

But while supportive therapy might help treat the symptoms, with no antibiotics available to treat the cause, we stay losing.
Until now:

…researchers have discovered an alternative: A donor’s stool can be transplanted in the intestine or colon of a sick patient via an enema,colonoscopy or nasogastric tube. The healthy bacteria fight off C. diff and re-establish a normal community in the gut.

Yep. Poo transplants. Regular (Lolz) readers may recall that we’ve had a quick look at this before, and then yesterday evening, this NYT article arrived from a medically qualified friend on Facebook, complete with smiley face attached.

It’s all about the world’s first “Stool Bank” and it’s beautifully written:

Around noon on a recent Friday, Donor Five, a healthy 31-year-old, walked across M.I.T.’s frigid, wind-swept campus to a third-floor restroom to make a contribution to public health.

Less than two hours later, a technician blended the donor’s stool into preparations that looked like chocolate milk. The material was separated and stored in freezers at an M.I.T. microbiology lab, awaiting shipment to hospitals around the country. Each container was carefully labeled: Fecal Microbiota Preparation.

There are issues though. The FDA are struggling to provide any sort of clarity on licensing of the treatment, meaning that donor poo can’t be sold for profit at the moment. And we know that large pharmaceutical companies are (understandably) reluctant to follow up on these things if there’s no money in them (another argument again).
Until the regulations are established, the research and the treatment can’t gain traction, but that’s not the biggest problem here. Because while there’s no traction in the research and treatment, people are taking matters into their own… er… hands: there exists the danger of an unregulated, unsafe Black… [shurely “Brown”? – Ed.] Market:

“People are doing fecal transplants in their basements and may not be doing any of the right screening or sterile preparation. We need an intermediate solution until there are commercial products on the market.”

What you get up to in your basement is entirely your business. Literally, it would seem in this case. But, even with my limited medical expertise, I would strongly advise against homemade faecal transplants.

Rather get a qualified doctor to fill your colon with someone else’s (screened) poo, should the need arise.

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