The Downside to Fecal Transplants
The title is a terrible joke. If you are suffering from Clostridium difficile- an infection terrible enough that the preferable alternative is a transplant of someone else’s poo, there may be a downside to getting that transplant besides just having to try very hard not to think about it for the rest of your life.
Dr. Kelly and Dr. Neha Alang of the Newport Hospital in Rhode Island recently reported a case where a 32 year-old patient received a transplant from her daughter. Though the patient had always maintained her weight, in the 16 months after the transplant she reported gaining 34 lbs, which increased to 41 after 36 month shad passed. The patient claimed to have attempted consistent diet and exercise but was unable to stave off the weight gain. The weight of the donor, a 16 year old girl, increased from 140-170 lbs over this same time period.
Animal studies have supported the notion that a fecal microbiota transplant from an obese donor can trigger obesity in the recipient, but in this case there was no micriobiome sequence available between the donor and recipient.
I’ll emphasize that this was a reported case not a study, Dr. Kelly added that other factors may have contributed to the weight gain, the illness itself or the fact that the patient recalled beginning oral contraceptives after the transplant. The purpose of the report is to initiate research on the matter as not much is presently known about long-term side effects. Additionally, donor/recipient pairs that consist of family members or spouses are subject to less testing which also contributes to the lack of information.
A critic of the report, Dr. Natasha Bagdasarian of Wayne State University, disagrees with the authors’ classification of the daughter as a ‘non-ideal’ donor as her BMI at the time of the transplant was only 26.4 which (despite not being a great system for measuring health), is barely above “ideal.”
Dr. Josbert Keller of Medisch Centrum Haaglanden in The Netherlands, weighed in and added that, while this case report does not prove any association between a fecal transplant and weight gain that obesity is a reasonable exclusion criteria for a fecal transplant as an obese patient will have different microbiota than a leaner patient.
A second report of a similar case was recently reported in New Orleans by Dr. Arnab Ray of the Oschner Clinic.
Image source: My texts with Bob.