Pediatric Gastroenterology, Hepatology & Nutrition  2016;19(3):214-220

doi:10.5223/pghn.2016.19.3.214

Failure of Fecal Microbiota Transplantation in a Three-Year-Old Child with Severe Refractory Ulcerative Colitis.

Hideki KUMAGAI 1 ; Koji YOKOYAMA ; Tomoyuki IMAGAWA ; Shun INOUE ; Janyerkye TULYEU ; Mamoru TANAKA ; Takanori YAMAGATA

Affiliations

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Keywords

Colectomy; Fecal microbiota transplantation; Gastrointestinal microbiome; Inflammatory bowel diseases; Pediatric ulcerative colitis

Country

Republic of Korea

Language

English

Abstract

Fecal microbiota transplantation (FMT) is a treatment designed to correct gut dysbiosis by administration of feces from a healthy volunteer. It is still unclear whether FMT for children with ulcerative colitis (UC) is effective or hazardous. Here we describe a young patient to have received FMT for UC. A three-year-old girl was admitted to our hospital with severe active UC, and treated with aminosalicylates and various immunosuppressive drugs. As remission was not achieved, we decided to try FMT before colectomy. We administered donor fecal material a total of six times by retention enema (×2) and via a nasoduodenal tube (×4) within 10 days. The patient developed abdominal pain and pyrexia after each FMT session. Analyses revealed the transferred donor fecal microbiota had not been retained by the patient, who ultimately underwent colectomy. The severity of the UC and/or timing of FMT may have partly accounted for the poor outcome.