{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T10:50:35Z","timestamp":1792839035589,"version":"4.5.0"},"reference-count":48,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","license":[{"start":{"date-parts":[[2017,10,30]],"date-time":"2017-10-30T00:00:00Z","timestamp":1509321600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2017,10,30]],"date-time":"2017-10-30T00:00:00Z","timestamp":1509321600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Hepatology"],"published-print":{"date-parts":[[2017,12]]},"abstract":"<jats:p>\n                    Recurrent hepatic encephalopathy (HE) is a leading cause of readmission despite standard of care (SOC) associated with microbial dysbiosis. Fecal microbiota transplantation (FMT) may improve dysbiosis; however, it has not been studied in HE. We aimed to define whether FMT using a rationally derived stool donor is safe in recurrent HE compared to SOC alone. An open\u2010label, randomized clinical trial with a 5\u2010month follow\u2010up in outpatient men with cirrhosis with recurrent HE on SOC was conducted with 1:1 randomization. FMT\u2010randomized patients received 5 days of broad\u2010spectrum antibiotic pretreatment, then a single FMT enema from the same donor with the optimal microbiota deficient in HE. Follow\u2010up occurred on days 5, 6, 12, 35, and 150 postrandomization. The primary outcome was safety of FMT compared to SOC using FMT\u2010related serious adverse events (SAEs). Secondary outcomes were adverse events, cognition, microbiota, and metabolomic changes. Participants in both arms were similar on all baseline criteria and were followed until study end. FMT with antibiotic pretreatment was well tolerated. Eight (80%) SOC participants had a total of 11 SAEs compared to 2 (20%) FMT participants with SAEs (both FMT unrelated;\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    = 0.02). Five SOC and no FMT participants developed further HE (\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    = 0.03). Cognition improved in the FMT, but not the SOC, group. Model for End\u2010Stage Liver Disease (MELD) score transiently worsened postantibiotics, but reverted to baseline post\u2010FMT. Postantibiotics, beneficial taxa, and microbial diversity reduction occurred with\n                    <jats:italic toggle=\"yes\">Proteobacteria<\/jats:italic>\n                    expansion. However, FMT increased diversity and beneficial taxa. SOC microbiota and MELD score remained similar throughout.\n                    <jats:italic toggle=\"yes\">Conclusion:<\/jats:italic>\n                    FMT from a rationally selected donor reduced hospitalizations, improved cognition, and dysbiosis in cirrhosis with recurrent HE. (H\n                    <jats:sc>epatology<\/jats:sc>\n                    2017;66:1727\u20131738)\n                  <\/jats:p>","DOI":"10.1002\/hep.29306","type":"journal-article","created":{"date-parts":[[2017,6,6]],"date-time":"2017-06-06T11:41:27Z","timestamp":1496749287000},"page":"1727-1738","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":598,"title":["Fecal microbiota transplant from a rational stool donor improves hepatic encephalopathy: A randomized clinical trial"],"prefix":"10.1097","volume":"66","author":[{"given":"Jasmohan S.","family":"Bajaj","sequence":"first","affiliation":[{"name":"Virginia Commonwealth University and McGuire VA Medical Center,Richmond,VA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zain","family":"Kassam","sequence":"additional","affiliation":[{"name":"OpenBiome,Somerville,MA"},{"name":"Massachusetts Institute of Technology,Cambridge,MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Fagan","sequence":"additional","affiliation":[{"name":"Virginia Commonwealth University and McGuire VA Medical Center,Richmond,VA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edith A.","family":"Gavis","sequence":"additional","affiliation":[{"name":"Virginia Commonwealth University and McGuire VA Medical Center,Richmond,VA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Liu","sequence":"additional","affiliation":[{"name":"George Mason University,Manassas,VA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9828-7235","authenticated-orcid":false,"given":"I. Jane","family":"Cox","sequence":"additional","affiliation":[{"name":"Institute of Hepatology London,Foundation for Liver Research,London,United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raffi","family":"Kheradman","sequence":"additional","affiliation":[{"name":"George Mason University,Manassas,VA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas","family":"Heuman","sequence":"additional","affiliation":[{"name":"Virginia Commonwealth University and McGuire VA Medical Center,Richmond,VA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Wang","sequence":"additional","affiliation":[{"name":"George Mason University,Manassas,VA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Gurry","sequence":"additional","affiliation":[{"name":"Massachusetts Institute of Technology,Cambridge,MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roger","family":"Williams","sequence":"additional","affiliation":[{"name":"Institute of Hepatology London,Foundation for Liver Research,London,United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masoumeh","family":"Sikaroodi","sequence":"additional","affiliation":[{"name":"George Mason University,Manassas,VA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Fuchs","sequence":"additional","affiliation":[{"name":"Virginia Commonwealth University and McGuire VA Medical Center,Richmond,VA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Alm","sequence":"additional","affiliation":[{"name":"Massachusetts Institute of Technology,Cambridge,MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Binu","family":"John","sequence":"additional","affiliation":[{"name":"Virginia Commonwealth University and McGuire VA Medical Center,Richmond,VA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leroy R.","family":"Thacker","sequence":"additional","affiliation":[{"name":"Virginia Commonwealth University and McGuire VA Medical Center,Richmond,VA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Riva","sequence":"additional","affiliation":[{"name":"Institute of Hepatology London,Foundation for Liver Research,London,United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Smith","sequence":"additional","affiliation":[{"name":"OpenBiome,Somerville,MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon D.","family":"Taylor\u2010Robinson","sequence":"additional","affiliation":[{"name":"Imperial College,London,United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick M","family":"Gillevet","sequence":"additional","affiliation":[{"name":"George Mason 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