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Background & Aim: Fecal microbial transplantation (FMT) provides to replace beneficial bacteria with more favorable
microbiomes in recipient with dysbiosis. The aim of the present study is to prospectively investigate the efficacy of FMT
by assessing the clinical and endoscopic response in patients with ulcerative colitis (UC) who had failed anti-inflammatory,
immunosuppressive and TNF-伪 inhibitors (Infliximab, Adalimumab) and therapy.
Methods: In this prospective and uncontrolled study, 79 patients with UC were included. All medications except mesalazine
were stopped 1 week before FMT. Colonoscopy was performed both before and after FMT. To assess the efficacy of FMT, Mayo
scores were calculated at week 0 and week 24. A total of 500 ml extracted fresh fecal suspension was administered into the 30
to 40 cm proximal of terminal ileum of recipients.
Results: After 3 years of FMT experience with 79 patients who have completed their 6 months on UC and different 184 FMT,
31 of the (39.2%) 79 patients showed clinical response (100% clinical + labaratory + fully responded endoscopically), and 23
of the 79 (29.1%) patients achieved clinical and endoscopic remission (labarotory 70%, clinically and endoscopically 50-75%
improvement) at week 24. Twenty patients (25.3%) were accepted as a nonresponder at the end of the week 24. There was no
significant difference among donors concerning both the rate of clinical remission and clinical response. No adverse events
were observed in the majority of patients during FMT and 24 weeks follow-up. Twenty five patients (31.65%) experienced mild
adverse events such as nausea, vomiting, abdominal pain, diarrhea, and fewer after FMT.
Conclusions: FMT could be considered as a promising rescue treatment modality before surgery in patients with refractory
UC. Besides, although the long-term results are unknown, FMT also appears to be definitely safer and more tolerable than the
immunosuppressive and TNF-伪 inhibitors (Infliximab, Adalimumab) therapy in patients with UC.