{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T17:43:38Z","timestamp":1793727818095,"version":"4.6.1"},"reference-count":41,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","license":[{"start":{"date-parts":[[2022,4,5]],"date-time":"2022-04-05T00:00:00Z","timestamp":1649116800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Hepatol Commun"],"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:p>Early data suggest fecal microbiota transplant (FMT) may treat hepatic encephalopathy (HE). Optimal FMT donor and recipient characteristics are unknown. We assessed the safety and efficacy of FMT in patients with prior overt HE, comparing five FMT donors. We performed an open\u2010label study of FMT capsules, administered 5 times over 3 weeks. Primary outcomes were change in psychometric HE score (PHES) and serious adverse events (SAEs). Serial stool samples underwent shallow shotgun metagenomic sequencing. Ten patients completed FMT administration and 6\u2010month follow\u2010up. Model for End\u2010Stage Liver Disease (MELD) score did not change after FMT (14 versus 14, <jats:italic toggle=\"yes\">p<\/jats:italic>\u00a0=\u00a00.51). Thirteen minor adverse events and three serious adverse events (two unrelated to FMT) were reported. One SAE was extended\u2010spectrum beta\u2010lactamase <jats:italic toggle=\"yes\">Escherichia coli<\/jats:italic> bacteremia. The PHES improved after three doses of FMT (+2.1, <jats:italic toggle=\"yes\">p<\/jats:italic>\u00a0&lt;\u00a00.05), after five doses of FMT (+2.9, <jats:italic toggle=\"yes\">p<\/jats:italic>\u00a0=\u00a00.007), and 4 weeks after the fifth dose of FMT (+3.1, <jats:italic toggle=\"yes\">p<\/jats:italic>\u00a0=\u00a00.02). Mean change in the PHES ranged from \u22121 to +6 by donor. Two taxa were identified by random forest analysis and confirmed by linear regression to predict the PHES\u2014 <jats:italic toggle=\"yes\">Bifidobacterium adolescentis<\/jats:italic> (adjusted <jats:italic toggle=\"yes\">R<\/jats:italic>\n                           <jats:sup>2<\/jats:sup> = 0.27) and <jats:italic toggle=\"yes\">B. angulatum<\/jats:italic> (adjusted <jats:italic toggle=\"yes\">R<\/jats:italic>\n                           <jats:sup>2<\/jats:sup> = 0.25)\u2014both short\u2010chain fatty acid (SCFA) producers. Patients who responded to FMT had higher levels of <jats:italic toggle=\"yes\">Bifidobacterium<\/jats:italic> as well as other known beneficial taxa at baseline and throughout the study. The FMT donor with poorest cognitive outcomes in recipients had the lowest fecal SCFA levels. <jats:italic toggle=\"yes\">Conclusion:<\/jats:italic> FMT capsules improved cognition in HE, with an effect varying by donor and recipient factors (NCT03420482).<\/jats:p>","DOI":"10.1002\/hep4.1950","type":"journal-article","created":{"date-parts":[[2022,4,5]],"date-time":"2022-04-05T14:11:05Z","timestamp":1649167865000},"page":"2079-2089","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":73,"title":["Fecal microbiota transplant improves cognition in hepatic encephalopathy and its effect varies by donor and recipient"],"prefix":"10.1097","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3188-7188","authenticated-orcid":false,"given":"Patricia P.","family":"Bloom","sequence":"first","affiliation":[{"name":"1259,Division of Gastroenterology,University of Michigan,Ann Arbor,Michigan,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Donlan","sequence":"additional","affiliation":[{"name":"1811,Harvard Medical School,Boston,Massachusetts,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariam","family":"Torres Soto","sequence":"additional","affiliation":[{"name":"Emory Medical School,Atlanta,Georgia,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Daidone","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology,Massachusetts General Hospital,Boston,Massachusetts,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Hohmann","sequence":"additional","affiliation":[{"name":"Division of Infectious Disease,Massachusetts General Hospital,Boston,Massachusetts,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raymond T.","family":"Chung","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology,Massachusetts General Hospital,Boston,Massachusetts,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2022,4,5]]},"reference":[{"key":"hep41950-bib-0001-20241129","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1016\/j.cgh.2016.09.157","article-title":"Hepatic encephalopathy is associated with mortality in patients with cirrhosis independent of other extrahepatic organ failures","volume":"15","year":"2017","journal-title":"Clin Gastroenterol Hepatol"},{"key":"hep41950-bib-0002-20241129","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1111\/liv.14680","article-title":"Factors associated with health\u2010related quality of life in patients with cirrhosis: a systematic review","volume":"41","year":"2021","journal-title":"Liver Int"},{"key":"hep41950-bib-0003-20241129","doi-asserted-by":"crossref","first-page":"1397","DOI":"10.1111\/apt.15749","article-title":"Outcomes after hepatic encephalopathy in population\u2010based cohorts of patients with cirrhosis","volume":"51","year":"2020","journal-title":"Aliment Pharmacol Ther"},{"issue":"5","key":"hep41950-bib-0004-20241129","article-title":"Non\u2010absorbable disaccharides versus placebo\/no intervention and lactulose versus lactitol for the prevention and treatment of hepatic encephalopathy in people with cirrhosis","volume":"2016","year":"2016","journal-title":"Cochrane Database Syst Rev"},{"key":"hep41950-bib-0005-20241129","doi-asserted-by":"crossref","first-page":"1003","DOI":"10.1016\/j.jhep.2020.01.017","article-title":"Microbiota changes and intestinal microbiota transplantation in liver diseases and cirrhosis","volume":"72","year":"2020","journal-title":"J Hepatol"},{"key":"hep41950-bib-0006-20241129","doi-asserted-by":"crossref","first-page":"1452","DOI":"10.1016\/j.jhep.2021.08.004","article-title":"Microbiome therapeutics for hepatic encephalopathy","volume":"75","year":"2021","journal-title":"J Hepatol"},{"key":"hep41950-bib-0007-20241129","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1053\/j.gastro.2020.09.038","article-title":"Fecal microbiota transplantation is highly effective in real\u2010world practice: initial results from the FMT national registry","volume":"160","year":"2021","journal-title":"Gastroenterology"},{"key":"hep41950-bib-0008-20241129","doi-asserted-by":"crossref","first-page":"1727","DOI":"10.1002\/hep.29306","article-title":"Fecal microbiota transplant from a rational stool donor improves hepatic encephalopathy: a randomized clinical trial","volume":"66","year":"2017","journal-title":"Hepatology"},{"key":"hep41950-bib-0009-20241129","doi-asserted-by":"crossref","first-page":"1690","DOI":"10.1002\/hep.30690","article-title":"Fecal microbial transplant capsules are safe in hepatic encephalopathy: a phase 1, randomized, placebo\u2010controlled trial","volume":"70","year":"2019","journal-title":"Hepatology"},{"key":"hep41950-bib-0010-20241129","doi-asserted-by":"crossref","first-page":"791","DOI":"10.1016\/j.cgh.2018.05.038","article-title":"Patients with cirrhosis require more fecal microbiota capsules to cure refractory and recurrent Clostridium difficile infections","volume":"17","year":"2019","journal-title":"Clin Gastroenterol Hepatol"},{"key":"hep41950-bib-0011-20241129","doi-asserted-by":"crossref","first-page":"2043","DOI":"10.1056\/NEJMoa1910437","article-title":"Drug\u2010resistant E. coli bacteremia transmitted by fecal microbiota transplant","volume":"381","year":"2019","journal-title":"N Engl J Med"},{"key":"hep41950-bib-0012-20241129","doi-asserted-by":"crossref","first-page":"1515","DOI":"10.1093\/cid\/ciu135","article-title":"Fecal microbiota transplant for relapsing Clostridium difficile infection using a frozen inoculum from unrelated donors: a randomized, open\u2010label, controlled pilot study","volume":"58","year":"2014","journal-title":"Clin Infect Dis"},{"key":"hep41950-bib-0013-20241129","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1186\/s12916-016-0680-9","article-title":"Oral, frozen fecal microbiota transplant (FMT) capsules for recurrent Clostridium difficile infection","volume":"14","year":"2016","journal-title":"BMC Med"},{"key":"hep41950-bib-0014-20241129","doi-asserted-by":"crossref","first-page":"789","DOI":"10.1111\/j.1478-3231.2009.02030.x","article-title":"Neurophysiological investigations of hepatic encephalopathy: ISHEN practice guidelines","volume":"29","year":"2009","journal-title":"Liver Int"},{"key":"hep41950-bib-0015-20241129","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1111\/j.1478-3231.2009.02009.x","article-title":"Neuropsychological assessment of hepatic encephalopathy: ISHEN practice guidelines","volume":"29","year":"2009","journal-title":"Liver Int"},{"issue":"Suppl 1","key":"hep41950-bib-0016-20241129","first-page":"S60","article-title":"Clinical neurophysiology of hepatic encephalopathy","volume":"5","year":"2015","journal-title":"J Clin Exp Hepatol"},{"key":"hep41950-bib-0017-20241129","doi-asserted-by":"crossref","first-page":"1122","DOI":"10.1002\/hep.26309","article-title":"The Stroop smartphone application is a short and valid method to screen for minimal hepatic encephalopathy","volume":"58","year":"2013","journal-title":"Hepatology"},{"key":"hep41950-bib-0018-20241129","doi-asserted-by":"crossref","first-page":"4088","DOI":"10.1093\/bioinformatics\/btaa277","article-title":"SHOGUN: a modular, accurate and scalable framework for microbiome quantification","volume":"36","year":"2020","journal-title":"Bioinformatics"},{"key":"hep41950-bib-0019-20241129","article-title":"Hypothesis testing and power calculations for taxonomic\u2010based human microbiome data","volume":"7","year":"2012","journal-title":"PLoS One"},{"key":"hep41950-bib-0021-20241129","first-page":"1","article-title":"Feature selection with the Boruta package","volume":"36","year":"2010","journal-title":"J Stat Softw"},{"key":"hep41950-bib-0022-20241129","doi-asserted-by":"crossref","first-page":"D561","DOI":"10.1093\/nar\/gkz1010","article-title":"MEGARes 2.0: a database for classification of antimicrobial drug, biocide and metal resistance determinants in metagenomic sequence data","volume":"48","year":"2020","journal-title":"Nucleic Acids Res"},{"key":"hep41950-bib-0023-20241129","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1016\/j.jcmgh.2019.04.008","article-title":"Predicting clinical outcomes of cirrhosis patients with hepatic encephalopathy from the fecal microbiome","volume":"8","year":"2019","journal-title":"Cell Mol Gastroenterol Hepatol"},{"key":"hep41950-bib-0024-20241129","doi-asserted-by":"crossref","first-page":"907","DOI":"10.1002\/lt.24754","article-title":"Liver transplant modulates gut microbial dysbiosis and cognitive function in cirrhosis","volume":"23","year":"2017","journal-title":"Liver Transpl"},{"key":"hep41950-bib-0025-20241129","doi-asserted-by":"crossref","first-page":"1601","DOI":"10.1038\/ajg.2013.221","article-title":"Large\u2010scale survey of gut microbiota associated with MHE Via 16S rRNA\u2010based pyrosequencing","volume":"108","year":"2013","journal-title":"Am J Gastroenterol"},{"key":"hep41950-bib-0026-20241129","doi-asserted-by":"crossref","first-page":"G168","DOI":"10.1152\/ajpgi.00190.2011","article-title":"Linkage of gut microbiome with cognition in hepatic encephalopathy","volume":"302","year":"2012","journal-title":"Am J Physiol\u2010Gastrointestinal Liver Physiol"},{"key":"hep41950-bib-0027-20241129","doi-asserted-by":"crossref","first-page":"1518","DOI":"10.1111\/apt.15265","article-title":"Targets to improve quality of care for patients with hepatic encephalopathy: data from a multi\u2010centre cohort","volume":"49","year":"2019","journal-title":"Aliment Pharmacol Ther"},{"key":"hep41950-bib-0028-20241129","article-title":"Shiga toxin\u2010producing Escherichia coli transmission via fecal microbiota transplant","volume":"72","year":"2021","journal-title":"Clin Infect Dis"},{"key":"hep41950-bib-0029-20241129","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1111\/apt.16148","article-title":"Systematic review: the global incidence of faecal microbiota transplantation\u2010related adverse events from 2000 to 2020","volume":"53","year":"2021","journal-title":"Aliment Pharmacol Ther"},{"key":"hep41950-bib-0030-20241129","doi-asserted-by":"crossref","first-page":"1627","DOI":"10.1016\/j.cgh.2020.06.051","article-title":"Fecal microbiota transplantation is safe and effective in patients with Clostridioides difficile infection and cirrhosis","volume":"19","year":"2021","journal-title":"Clin Gastroenterol Hepatol"},{"key":"hep41950-bib-0031-20241129","doi-asserted-by":"crossref","first-page":"1555","DOI":"10.1136\/gutjnl-2020-321829","article-title":"Reorganisation of faecal microbiota transplant services during the COVID\u201019 pandemic","volume":"69","year":"2020","journal-title":"Gut"},{"key":"hep41950-bib-0032-20241129","doi-asserted-by":"crossref","first-page":"2635","DOI":"10.1053\/j.gastro.2020.12.057","article-title":"Fecal microbiota transplantation \u201cdonor effects\u201d are not clinically relevant for Clostridioides difficile infection","volume":"160","year":"2021","journal-title":"Gastroenterology"},{"key":"hep41950-bib-0033-20241129","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1093\/ecco-jcc\/jjaa170","article-title":"Re\u2010evaluating the evidence for faecal microbiota transplantation 'super\u2010donors' in inflammatory bowel disease","volume":"15","year":"2021","journal-title":"J Crohns Colitis"},{"key":"hep41950-bib-0034-20241129","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1111\/apt.14397","article-title":"Review article: the gut microbiome as a therapeutic target in the pathogenesis and treatment of chronic liver disease","volume":"47","year":"2018","journal-title":"Aliment Pharmacol Ther"},{"key":"hep41950-bib-0035-20241129","doi-asserted-by":"crossref","first-page":"100674","DOI":"10.1016\/j.conctc.2020.100674","article-title":"Power calculations for detecting differences in efficacy of fecal microbiota donors","volume":"20","year":"2020","journal-title":"Contemp Clin Trials Commun"},{"key":"hep41950-bib-0036-20241129","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1038\/s41575-021-00441-5","article-title":"Recipient factors in faecal microbiota transplantation: one stool does not fit all","volume":"18","year":"2021","journal-title":"Nat Rev Gastroenterol Hepatol"},{"key":"hep41950-bib-0037-20241129","doi-asserted-by":"crossref","first-page":"3593","DOI":"10.1128\/AEM.72.5.3593-3599.2006","article-title":"Two routes of metabolic cross\u2010feeding between Bifidobacterium adolescentis and butyrate\u2010producing anaerobes from the human gut","volume":"72","year":"2006","journal-title":"Appl Environ Microbiol"},{"key":"hep41950-bib-0038-20241129","doi-asserted-by":"crossref","first-page":"110831","DOI":"10.1016\/j.biopha.2020.110831","article-title":"Bifidobacterium adolescentis supplementation attenuates fracture\u2010induced systemic sequelae","volume":"132","year":"2020","journal-title":"Biomed Pharmacother"},{"key":"hep41950-bib-0039-20241129","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1007\/s00253-018-9454-y","article-title":"Bifidobacterium adolescentis CGMCC 15058 alleviates liver injury, enhances the intestinal barrier and modifies the gut microbiota in D\u2010galactosamine\u2010treated rats","volume":"103","year":"2019","journal-title":"Appl Microbiol Biotechnol"},{"key":"hep41950-bib-0040-20241129","doi-asserted-by":"crossref","first-page":"2312","DOI":"10.1128\/AEM.02649-08","article-title":"Coculture fermentations of Bifidobacterium species and Bacteroides thetaiotaomicron reveal a mechanistic insight into the prebiotic effect of inulin\u2010type fructans","volume":"75","year":"2009","journal-title":"Appl Environ Microbiol"},{"key":"hep41950-bib-0041-20241129","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1007\/s12072-019-10004-1","article-title":"Antimicrobial resistance in chronic liver disease","volume":"14","year":"2020","journal-title":"Hepatol Int"},{"key":"hep41950-bib-0042-20241129","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1002\/hep4.1639","article-title":"Fecal microbiota transplant in cirrhosis reduces gut microbial antibiotic resistance genes: analysis of two trials","volume":"5","year":"2021","journal-title":"Hepatol Commun"}],"container-title":["Hepatology Communications"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hep4.1950","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/hep4.1950","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.lww.com\/10.1002\/hep4.1950","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,29]],"date-time":"2024-11-29T13:05:19Z","timestamp":1732885519000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1002\/hep4.1950"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4,5]]},"references-count":41,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2022]]}},"URL":"https:\/\/doi.org\/10.1002\/hep4.1950","relation":{},"ISSN":["2471-254X","2471-254X"],"issn-type":[{"value":"2471-254X","type":"print"},{"value":"2471-254X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,4,5]]},"assertion":[{"value":"2021-11-22","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-03-12","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}