TRANSPLANT TRIALS
Canadian health administrators, who until recently shunned fecal transplants as unproven and risky, are permitting experimental treatment in several hospitals. Health Canada, while not endorsing fecal transplants, is allowing “investigational” clinical trials:
A “fresh-verses-frozen” fecal transplant trial involving 156 patients is underway at McMaster University in Hamilton, Ont., and expanding to include patients in Vancouver, Edmonton and Kingston, Ont. Six donors provide the feces. If frozen stool works as well as transplants with fresh feces, they could be stored in “poop” banks and used in hospitals that don’t have microbiology labs or have access to screened donors.
“RePOOPulate,” created by Emma Allen-Vercoe at the University of Guelph, aims to reduce fecal transplants to the essential microbial players capable of restoring healthy gut ecosystems. Allen-Vercoe and her colleague, Dr. Elaine Petrof at Queen’s University, have tested their RePOOPulate mixture of 33 strains of fecal microbes on two elderly people, who were both quickly cured of their recurrent C. difficile.
Pills packed with fecal microbes could make fecal transplants even more palatable. Dr. Thomas Louie’s group at the Peter Lougheed Hospital in Calgary is custom-making capsules packed with microbes harvested from fresh feces. Ninety minutes after the capsules are swallowed, they release their living cargo into the intestine. The microbes start to multiply and establish a healthy gut ecosystem. Louie reports the pills, swallowed by about 40 patients, work as well if not better than the fecal transplants he has administered by enema.
Dr. Susy Hota, at Toronto’s University Health Network, is recruiting 140 people with recurrent C. difficile for a trial that aims to compare fecal transplants with standard drug treatment. She feels it is premature to start offering fecal transplants as routine therapy.