{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T23:47:26Z","timestamp":1791848846436,"version":"4.3.4"},"reference-count":62,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Alcohol-related liver disease (ALD) affects 4.8% of the global population. Among these patients, between 13.4% and 19.6% suffer from alcoholic hepatitis (AH), which, in its severe form, is associated with significant short- and long-term mortality. Current therapeutic options are limited, offering only modest short-term survival benefits. Recent studies suggest that microbiota-based therapies may offer a novel therapeutic opportunity for patients with ALD. Methods: Databases including Embase, Medline, and CENTRAL were searched until 4 February 2026. The pre-registered protocol on PROSPERO (CRD42023467455) was followed without deviation. Studies comparing adult patients with ALD, treated with fecal microbiota transplantation (FMT) or standard of care (SOC), were included. Outcomes investigated included overall survival, alcoholic recidivism, adverse events (AEs), and disease severity scores. Risk of bias (ROB) was assessed using the ROBINS-I and ROB 2 tools. Hazard ratios (HR) were calculated for FMT versus SOC groups. Results: Overall, 10 studies were eligible for inclusion, with 339 patients eligible for synthesis. In these patients, FMT was associated with significantly improved overall survival compared to the SOC, with an HR of 0.50 (95% confidence interval (CI): 0.35\u20130.72; p = 0.0002). When comparing FMT with pentoxifylline, the HR was 0.45 (95% CI: 0.21\u20130.96; p = 0.0345), and when FMT was compared with nutritional support alone, the HR was 0.36 (95% CI: 0.19\u20130.66; p = 0.0001). But FMT did not reach statistical significance when compared to glucocorticoids. ROB analysis showed a moderate to high risk of bias, and the overall certainty of evidence was low. Discussion: FMT is a promising therapeutic option for improving short- and medium-term survival in patients with severe alcoholic hepatitis (SAH), particularly in those who are ineligible or unresponsive to corticosteroid therapy. However, given the risk of bias and low certainty of evidence, clinical significance remains uncertain. Confirmation in well-designed studies is needed.<\/jats:p>","DOI":"10.3390\/jcm15135131","type":"journal-article","created":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T12:41:38Z","timestamp":1782909698000},"page":"5131","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Fecal Microbiota Transplantation Is Associated with Better Survival Compared to Standard of Care in Severe Alcoholic Hepatitis Not Responding to Corticosteroids: A Systematic Review and Meta-Analysis"],"prefix":"10.3390","volume":"15","author":[{"given":"Jakub","family":"Hoferica","sequence":"first","affiliation":[{"name":"Centre for Translational Medicine, Semmelweis University, 1085 Budapest, Hungary"},{"name":"Jessenius Faculty of Medicine in Martin, Comenius University, 03601 Martin, Slovakia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6809-9989","authenticated-orcid":false,"given":"Bettina Csilla","family":"Budai","sequence":"additional","affiliation":[{"name":"Centre for Translational Medicine, Semmelweis University, 1085 Budapest, Hungary"},{"name":"Institute of Pancreatic Diseases, Semmelweis University, 1083 Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2276-7109","authenticated-orcid":false,"given":"Eszter \u00c1gnes","family":"Szalai","sequence":"additional","affiliation":[{"name":"Centre for Translational Medicine, Semmelweis University, 1085 Budapest, Hungary"},{"name":"Department of Restorative Dentistry and Endodontics, Semmelweis University, 1088 Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c1d\u00e1m","family":"Zolcs\u00e1k","sequence":"additional","affiliation":[{"name":"Centre for Translational Medicine, Semmelweis University, 1085 Budapest, Hungary"},{"name":"Department of Biophysics and Radiation Biology, Semmelweis University, 1094 Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4269-5130","authenticated-orcid":false,"given":"Marie Anne","family":"Engh","sequence":"additional","affiliation":[{"name":"Centre for Translational Medicine, Semmelweis University, 1085 Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katalin","family":"Lenti","sequence":"additional","affiliation":[{"name":"Centre for Translational Medicine, Semmelweis University, 1085 Budapest, Hungary"},{"name":"Department of Morphology and Physiology, Faculty of Health Sciences, Semmelweis University, 1088 Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P\u00e9ter","family":"Hegyi","sequence":"additional","affiliation":[{"name":"Centre for Translational Medicine, Semmelweis University, 1085 Budapest, Hungary"},{"name":"Institute of Pancreatic Diseases, Semmelweis University, 1083 Budapest, Hungary"},{"name":"Institute for Translational Medicine, Medical School, University of P\u00e9cs, 7624 P\u00e9cs, Hungary"},{"name":"Translational Pancreatology Research Group, Interdisciplinary Centre of Excellence for Research Development and Innovation University of Szeged, 6720 Szeged, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5008-2153","authenticated-orcid":false,"given":"Jun","family":"Yu","sequence":"additional","affiliation":[{"name":"Institute of Digestive Disease and Department of Medicine and Therapeutics, State Key Laboratory on Digestive Disease, Li Ka Shing Institute of Health Science, Chinese University of Hong Kong, Hong Kong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P\u00e9ter Jen\u0151","family":"Hegyi","sequence":"additional","affiliation":[{"name":"Centre for Translational Medicine, Semmelweis University, 1085 Budapest, Hungary"},{"name":"Institute of Pancreatic Diseases, Semmelweis University, 1083 Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Banovcin","sequence":"additional","affiliation":[{"name":"Centre for Translational Medicine, Semmelweis University, 1085 Budapest, Hungary"},{"name":"Jessenius Faculty of Medicine in Martin, Comenius University, 03601 Martin, Slovakia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2493","DOI":"10.1016\/S0140-6736(18)32744-2","article-title":"Global alcohol exposure between 1990 and 2017 and forecasts until 2030: A modelling study","volume":"393","author":"Manthey","year":"2019","journal-title":"Lancet"},{"key":"ref_2","unstructured":"Niu, X., Zhu, L., Xu, Y., Zhang, M., Hao, Y., Ma, L., Li, Y., and Xing, H. 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