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A little over a year ago, Lifeblood became the first TGA-licensed FMT manufacturer in Australia, and the only national not-for-profit manufacturer of FMT. It was a game-changing moment that gave hope to countless Australians, but our work has only just begun. Over the past 12 months, the Microbiome Team has been working around the clock to screen and recruit healthy people to become microbiota donors. To find out how the use of this incredible treatment is progressing and how it works, we spoke with the doctors and experts that have made it all possible.
“He was sitting up in bed and he was eating. And he just said, “I'm better.””
In layman’s terms, a faecal microbiota for transplant is a way to treat digestive diseases through a poo transplant. A healthy person can donate their faecal microbiota which is teeming with good bacteria and give it to someone who has an imbalance in their gut. Many kinds of bacteria can cause this type of imbalance. Lifeblood is using FMT to treat a particularly nasty bacterial infection of the gut caused by Clostridioides difficile or or C.diff for short. This bacterium has proven to be resistant to some of the most powerful antibiotics available, and for many patients who receive an FMT, it is quite literally their last hope.
Dr Oliver Waters is a gastroenterologist and one of the lead clinicians running a C.diff trial at our partner, Fiona Stanley Hospital. To illustrate the severity of C.diff and the impact FMT can have, he recounted an incredible story about the first time he ever used the treatment, ‘I came across a patient…who had developed C.diff. Over a six-month period, he'd spent 100 days in hospital, including several trips to intensive care. He'd come very, very close to having his bowel removed, and he was just having an absolutely miserable time. At the same time, there was a seminal paper that was published in the New England Journal of Medicine that showed faecal microbiota transplantation had an 80% efficacy for treating recurrent relapsing C.diff. So, myself and Lauren Mannings – who’s an infectious disease [specialist] – we were both looking after this [patient] and we said, you know, shall we do it? Cause we've got nothing else left. We did the [transplant] at about eleven o'clock in the morning. I went to see him four hours later on the ward. And he was sitting up in bed and he was eating. And he just said, “I'm better.”’
Currently, Lifeblood’s FMT products have a success rate of over 90%, so one thing we can say for certain is – it works! We know the introduction of good bacteria into an unhealthy gut has a positive impact, but the human digestive system is incredibly complex. Uncovering the exact mechanisms or processes that allow this positive change to take place is still being investigated.
One of the Microbiology Medical Specialists working in this area is Dr Anindita Das, she explains how the exact curative mechanism is still unknown, “So when we give the [FMT], we think that it could be the bacteria. But maybe it's not, maybe it's some supernatant chemical [or] a product of the bacteria. And in the future, research may help us identify what the magic ingredient or ingredients are.”
If we can better understand why FMT works, not only can we improve the way we treat C.diff, but we’ll have a better understanding of how we can treat other digestive diseases and potentially a whole range of other health conditions.
The success of FMT has drawn attention from across the medical community. With a high quality, safe FMT treatment now available from Lifeblood’s TGA licensed facility, research can now be undertaken to explore how microbiota might be used for the treatment of other gastrointestinal diseases (such as ulcerative colitis), psychiatric diseases, and in conjunction with treatments for cancer – health conditions which we know greatly impact Australians.
Dr Jesica Makanyanga, a gastroenterologists at Fiona Stanley Hospital and one of the lead clinicians running the C.diff trial, explains her vision for the future, ‘I think my hope would be that we have medical microbiota products which are much more specific for conditions like Clostridium difficile…I think other conditions [FMT could be used for], include all sorts of colitis, maybe Crohn's disease, maybe some types of functional GI disorder…and at the very least, it would be nice if that could be given as a capsule, in a reliable way.’
It's clear we’ve only begun to explore the potential application of FMT and other faecal microbiota-based treatments. What we will be able to treat in the future all comes down to the work we do today, but the Microbiome Team can’t do it alone. These treatments depend on the generosity of donors. People willing to give a part of themselves for the benefit of others. If you’re living in Perth or the surrounding areas and want to help those suffering from a debilitating, life-threatening disease, take the microbiota eligibility quiz and see if you’ve got the guts to save lives.
Lifeblood acknowledges and pays our respect to the past, present and future Traditional Custodians and Elders of this nation and the continuation of cultural, spiritual and educational practices of Aboriginal and Torres Strait Islander peoples.
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