Faecal microbiota transplantation associated adverse events

Abstract Faecal microbiota transplantation (FMT) aims to restore intestinal microbiota balance with the objective of normalising its composition and achieve therapeutic benefits. The procedure involves the administration of fresh or frozen faecal microbes from a healthy donor into the recipient’s gastrointestinal tract with the intent to restore the proper structure and functionality of the recipient’s intestinal microbial community. Evidence showing the positive effects of FMT is abundant, however, less attention has been devoted to FMT-associated adverse events, especially in relation to liver diseases. Based on literature review, studies and reports regarding FMT-associated adverse events since the beginning of FMT use, have been analysed. The review covering the period 2010-2022 was undertaken in accordance with the PRISMA guidelines. Studies conducted on the patient population suffering from various types and forms of liver disease have proven the possible effectiveness of the FMT method and reported moderate adverse events (nausea, constipation, flatulence). Severe adverse events occurring in relation to FMT were also noted. No safety issues or infection signals associated with FMT were observed in studies performed within the population suffering from cirrhosis. The present review of scientific reports, publications and literature reviews describes the adverse events reported in the literature. Faecal microbiota transplants are associated with adverse events classified as mild, moderate and severe, among others, diarrhoea, fever, infections or death. There is a need to implement a donor screening programme and personalised transplantation methods. Further research is recommended to assess and monitor FMT efficacy, benefits and risks.