P696 Faecal microbiota transplantation in ultra-refractory ulcerative colitis: Retrospective analysis in a tertiary care centre

Abstract

Background: Colonic disbiosis is suspected to be an important factor in the physiopathology of ulcerative colitis (UC). Faecal microbiota transplantation (FMT) could play a therapeutic role because of its ability in restore a normal colonic microbiota. Some randomised trials have compared FMT vs. placebo with hopeful results. Method(s): Observational study of patients diagnosed with ultrarefractory UC (to several lines of immunosuppressive and biological therapy) treated with FMT in a tertiary care centre. FMT was performed with stool from a single donor per procedure, according to centre protocol and exposing in vitro receptor's mucosal lymphocytes to donor's stool, selecting the donor with less inflammatory response (Ponce-Alonso, M. et al. ECCO 2017). Faecal filtrate was applied by colonoscopy, followed by enemas in weeks 1-2-3-4 and new colonoscopic dose in week 16. Result(s): Four patients were included (Table 1), with a median age of 50 years. None of patients included showed an improvement in clinical activity score (Walmsley), biologic markers (C-Reactive Protein, faecal calprotectine), or colonoscopy. (Table presented) Conclusion(s): In our experience, FMT was not useful in the management of ultra-refractory UC. Due to small sample size it is difficult to obtain conclusions, but maybe FMT should be employed in earlier phases of the disease.