June 6, 2023
Fecal Microbiota Transplants (FMT) have been shown to work consistently well for the treatment of C difficile colitis, and though not as effective, they have also proven successful in treating conditions such as Crohn’s and ulcerative colitis. The mechanisms of how FMT works are not fully understood. New research has emerged to suggest that FMT success is largely dependent on the donors microbial composition.
According to researchers out of the University of Auckland, certain people are, what is being called, “super donors”. They are people with seemingly magical healing poop, poop that more so than other stool has the consistent ability to induce remission in patients with IBD.
So what makes a super donor? We answer that question in more in the following sections:
The classification of a super donor are outlined in the following section.
Super donors are those with a particular microbial composition that makes their stool particularly effective in treating patients with dysbiosis. Stool from super donors has a greater potential to relieve the symptoms of conditions such as Crohn’s and Ulcerative Colitis. Scientists have not yet deciphered what makes their stool so great; only that it is likely due to the composition of their microbiomes.
FMT is 52% and 33% effective in inducing remissions in Crohn’s and Colitis, respectively. Those numbers may even be higher when isolating for patients given stool from those dubbed “super donors”. And though researchers are now aware of the existence of said super donors, they currently do not have any way of predicting who they are.
The next steps in studying the use of fecal transplants will surely be to find what makes an effective transplant by evaluating different microbial criteria in donors.
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"Designer Shit" director Saffron Cassaday interview Dr Paul Moayyedi.[/caption]
In a study out of McMaster University, researchers attempting to demonstrate the efficacy of FMT for the treatment of Ulcerative Colitis found that one particular donor had far more success treating patients than others. The donor, known infamously as Donor B, had more successes than any other donor, contributing most of the studies positive results.
Lead researcher Dr Paul Moayyedi said, “There were five donors in total, but we used mainly two. What we can say is, no one responded to Donor A, and most of our responses came from Donor B.” This particular study saw 40% of patients with improved conditions from FMT, and the majority received stool from Donor B.
As the studies donors are anonymous, Donor B’s identity is unknown to those who’s conditions they have improved.
A participant of the study who was interviewed for our film “Designer Shit” told director Saffron Cassaday, “So far I've heard that everybody that has used his transplant or his samples I guess has gone into remission, so I'm quite thankful for Donor B.” The patient, Amanda Knox, still enjoys remission from her symptoms thanks to “super Donor B”.
As of yet there is not enough research to identify what the ideal microbiome of a donor in looks like. The current process of identifying suitable FMT donors involves, multiple tests and health questionnaires. But as of now the only way to know if a suitable donor is also a super donor is by testing their stool in practice.
Donors must be in great health but it turns out there is more to being a good donor than just being impeccable healthy. There seems to be particular microbial compositions that are more effective in treating dysbiosis than others. One way this knowledge may be studied and implemented in the future is through dysbiosis matched donors.
The future of FMT may lie in finding dysbiosis matched donors for patients. This means using donors with a microbiome composition that fills the gaps in an ill person's microbiome that result cause their dysbiosis.
A lot more research will be needed but in theory, if scientists can identify what particular microbes are missing they can find someone with stool fit to replace them. For example someone with autism who has certain missing or deficient microbes can find someone with those microbes and use their stool to alleviate their dysbiosis and in turn alleviate the symptoms of their autism.
If you think you may be a super donor, check out this article and find out how you can become a donor. You might even get paid for your poop.
Still interested in how super donors produce better outcomes. Check out this article from The Scientist.
Stool for fecal transplants has to come from somewhere. Learn more about stool banks and who is donating their stool and why.