Therapeutic opportunities of fecal microbiota transplantation in the treatment of non-alcoholic fatty liver disease

Based on the emerging evidence in the crosstalk between gut microbiota composition and the non-alcoholic fatty liver disease (NAFLD), the application of fecal microbiota transplantation (FMT) on patients with NAFLD has become an attractive research field. Evidence from multiple studies have proved that lean patients with NAFLD were more sensitive to FMT in both microbiomic and metabolic aspects compared to obese patients, and more benefits were observed in patients receiving allogenic FMT from lean donors compared to those receiving autologous FMT, possibly due to the benefits derived from the successful engraftment of donor’s microbiota post FMT. However, it has been observed from the clinical practice that an identified successful engraftment is not a promise of clinical efficacy in NAFLD patients. This review aims to summarize the current evidence supporting application of FMT in treatment of NAFLD. We realized that the clinical efficacy and long-term benefits of FMT on NAFLD patients warrant further investigation with more properly-designed randomized controlled trials.