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Fecal microbiota transplant improves brain function in hepatic encephalopathy

PARIS — Patients who underwent fecal microbiota transplant for recurrent hepatic encephalopathy had a lower risk for hospitalization and showed improve gut microbiome and brain function, according to this exclusive interview from the International Liver Congress 2018.

“These were patients ... who actually had multiple episodes of encephalopathy,” Jasmohan S. Bajaj, MD, from the Virginia Commonwealth University, told Healio Gastroenterology and Liver Disease. “We sought to treat the dysbiosis — which means the unbalanced gut microbiota — by a stool transplant from one donor. This one donor was selected to have the highest amount of the good bacteria.”

Bajaj discussed his presentation on a follow-up study of patients with recurrent hepatic encephalopathy who survived 5 months after a fecal microbiota transplant or standard of care. At 1 year from transplant, outcomes included one mortality in the FMT arm and three patients in the standard of care arm who died or underwent liver transplantation.

Among the remaining patients, patients who received FMT were less likely to have an episode of hepatic encephalopathy (median 0; range, 0-1) or be hospitalized (median 0; range 0-1.5) compared with episode rates (median 1.5; range, 0.75-2.75) and hospitalization rates (median 3; range, 0.75-5.75) in those who received standard of care.

The FMT arm also demonstrated significant improvements in cognitive function and their gut microbiota demonstrated changes in function and composition.

“Hepatic encephalopathy is a debilitating condition and a major burden to patients and caregivers, and new therapies are urgently needed,” Annalisa Berzigotti, MD, PhD, from the University of Bern, Switzerland, and EASL Governing Board Member, said in a press release for the presentation. “This study provides an important piece of evidence. The encouraging long-term results of FMT in [hepatic encephalopathy] strongly support the need for a larger, multicenter study of this intervention.”

For more information:

Bajaj J, et al. PS-016. Presented at: International Liver Congress; Apr. 11-15, 2018; Paris, France.

Disclosure: Bajaj reports no relevant financial relationships.

PARIS — Patients who underwent fecal microbiota transplant for recurrent hepatic encephalopathy had a lower risk for hospitalization and showed improve gut microbiome and brain function, according to this exclusive interview from the International Liver Congress 2018.

“These were patients ... who actually had multiple episodes of encephalopathy,” Jasmohan S. Bajaj, MD, from the Virginia Commonwealth University, told Healio Gastroenterology and Liver Disease. “We sought to treat the dysbiosis — which means the unbalanced gut microbiota — by a stool transplant from one donor. This one donor was selected to have the highest amount of the good bacteria.”

Bajaj discussed his presentation on a follow-up study of patients with recurrent hepatic encephalopathy who survived 5 months after a fecal microbiota transplant or standard of care. At 1 year from transplant, outcomes included one mortality in the FMT arm and three patients in the standard of care arm who died or underwent liver transplantation.

Among the remaining patients, patients who received FMT were less likely to have an episode of hepatic encephalopathy (median 0; range, 0-1) or be hospitalized (median 0; range 0-1.5) compared with episode rates (median 1.5; range, 0.75-2.75) and hospitalization rates (median 3; range, 0.75-5.75) in those who received standard of care.

The FMT arm also demonstrated significant improvements in cognitive function and their gut microbiota demonstrated changes in function and composition.

“Hepatic encephalopathy is a debilitating condition and a major burden to patients and caregivers, and new therapies are urgently needed,” Annalisa Berzigotti, MD, PhD, from the University of Bern, Switzerland, and EASL Governing Board Member, said in a press release for the presentation. “This study provides an important piece of evidence. The encouraging long-term results of FMT in [hepatic encephalopathy] strongly support the need for a larger, multicenter study of this intervention.”

For more information:

Bajaj J, et al. PS-016. Presented at: International Liver Congress; Apr. 11-15, 2018; Paris, France.

Disclosure: Bajaj reports no relevant financial relationships.

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