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DONOR Screening and Selecting for Fecal Microbiota Transplantation Therapy

How to Screen and Select a Healthy Donor? Who can be a Donor for FMT?

Written by White Shark, 2009


Fecal microbiota transplantation (FMT)  is the process of transplantation of healthy feces from a healthy individual (donor) into a not as healthy individual (recipient). If you have any general questions about this therapy, (why, who, really?) please click here to read all answers.


How to select a Healthy DONOR for FMT?

Who can be a donor?

A donor is selected based on his/her health. Safety is very important, so all precautions should be taken to avoid implanting feces infected with parasites or dangerous bacteria like for example clostridium difficille.   Click here to read about basic donor requirements.

Special Donor Requirements!

If the recipient of the FMT transplant is a person suffering from food allergies or food intolerance, special donor requirements must be satisfied to make FMT a safe procedure!

If the recipient of the feces is extremely allergic to some food items, the donor must not consume those foods for at least 10-14 days prior to starting FMT procedure, depending on food allergy.
Othervise, the FMT procedure may kill the recipient or may make him very sick!
For example, if the recipient is allergic to peanuts, the donor must not consume any peanuts for at least 14 days prior to starting FMT procedure.

If the recipient of the feces is intolerant of some food items, the donor must not consume those foods for at least 5-10 days prior to starting FMT procedure, depending on food intolerance.
Othervise, the FMT procedure may make the recipient very sick!
For example, if the recipient is intolerant of gluten or milk, the donor must not consume any gluten or milk at least 7-10 days prior to starting FMT procedure.


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The fast and easy way forward: Family member or a child as a donor

A relatively safe way to choose a donor (in developed countries) is to choose a feces from a very healthy, breastfed young child.
It takes about 3 years for microbiota to get fully developed.
Fully developed microbiota can contain up to 1000 different strains of bacteria.
So, you are looking for a healthy child, at least 3 years old, or older.

There are very many  advantages in choosing a healthy child as a donor compared to selecting an adult donor

  • does not need to be tested for sexually transmitted diseases, if mother and child are healthy. In most developed countries, mothers are repeatedly tested for blood born sexually transmitted diseases (STDs) and for many other diseases during pregnancy. Newborn babies are also routinly tested for blood born diseases. If mother have tested negative for STDs, and the baby was tested negative for STD, then once that bay is 3 years old, it can be a safe FMT donor.  Any child of pre-sexual age is considered a safe donor in regards to STDs. Most babies are also tested after birth (hospital birth), both for blood born STDs and for a long list of other diseases so  that requirement is satisfied by default.
  • a healthy child may not need to be tested for intestinal bacteria or intestinal parasites, if the child is healthy, and if mother and the child have never traveled to tropical countries.
  • healthy kids are never addicted to alcohol, narcotics, legal or illegal drugs, so that requirement is satisfied by default.
  • healthy young kids have no dental fillings,  that requirement is satisfied by default.
  • healthy kids have never suffered from any chronic disease or chronic health problem, so that requirement is satisfied by default..
  • healthy kids usually eat healthy diet,  that requirement is satisfied by default.
  • healthy kids have healthy digestion and healthy poop, what can be easily inspected.
  • very easy to get a fresh feces, all you need to do is collect it from a potti. Far more convenient than dealing with adult poop.
  • kids poop smells much better than adult poop!

The child should be very healthy, never treated with antibiotics and never treated with ANY oral or any other medications. The child  should not be underweight or overweight.  Never suffered from chronic diarrhea or chronic constipation.
To be on the safe side, the mother of the child should have never traveled to tropical countries.

Feces from the potti or from dipers::
Get fresh feces. Color of feces must be brown or brown-yellow, it must not be green, cause green color of feces almost always indicates lack of good and healthy bowel bacteria. (Unless child was drinking freshly pressed wheat grass juice, or consumed blueberries, or some other food of strong green or blue color, green color of feces always indicates lack of good bowel bacteria. Yellow (or yellow-brown, or brown if child has eaten meat) color indicates healthy feces.)

 

Here is a list of basic requirements an individual has to satisfy to be selected as a donor for FMT:
( quite many of those requirements are automatically satisfied if the donor is a young child, at least 3 years old)

  • born by natural vaginal birth (ask donors mother)
  • breast fed by mother for at least 8 months or longer (ask donors mother)
  • donors mother never used any prescription medications during pregnancy, especially not antibiotics
  • donor is generally very healthy person
  • never tested positive for sexually transmitted diseases (STD) like: HIV, Hepatitis C, B, A, Syphilis, Gonorrhea, Herpes
  • not sexually promiscuous ( sexual promiscuity increases likeliness of an STD infection)
  • not practicing anal sex ( practicing anal sex increases likeliness of being infected with intestinal parasites or intestinal bacteria)
  • to be on the safe side, a sexually active donor should have taken an STD test during the last few months, if possible.
  • never been infected with intestinal parasites or blood parasites or dangerous intestinal bacteria
  • never traveled to third world tropical countries ( traveling to  third world tropical countries increases likeliness of being infected with intestinal parasites, dangerous intestinal bacteria or dangerous virus )
  • never suffered from travelers diarrhea
  • perfectly healthy digestion, no chronic digestive problems
  • never suffered from any chronic or serious diseases
  • never suffered from any chronic pain, including but not limiting to: chronic headaches, migraine, joint pains, chronic back or neck pain, arm pain, leg pain, foot pain etc.
  • never suffered from any mental illness like depression, anxiety, schizophrenia, etc.
  • not addicted to alcohol, narcotics, tobacco, legal or illegal drugs
  • has regular bowel movements, 1-2 per day,  healthy color of feces (brown - brown yellow), healthy smell of feces (not too strong smell), healthy shape of feces, nicely formed, rounded, not too large, not too small
  • healthy body weight, not obese, not underweight
  • healthy skin, healthy hair and healthy nails: never suffered from chronic acne, chronic peeling lips, hair loss, eczema, psoriasis, seborrheic dermatitis, allergies, hives, boils, warts, etc.
  • never suffered from chronic unpleasant body odor, bad breath, inflamed tonsils, tonsil stones
  • never suffered from chronic vision problems
  • never treated with oral antibiotics or at least not treated with oral antibiotics during the last 5 years
  • healthy teeth and healthy gums. At least not having large number of amalgam fillings in his/her mouth
  • if it is a fertile woman, she should have a regular menstrual cycle.   Feces should not be taken during the days of  menstruation.
  • if it is a woman, she should not be using hormonal birth control like Mirena IUD or any other IUD, or any other hormonal pills.
  • never suffered from any chronic disease or any other diseases, including but not limiting to: inflammatory bowel diseases like ulcerative colitis and Crohn's disease, irritable bowel syndrome, any form of cancer, Fibromyalgia, any tumor, cyst, Parkinson's disease, Multiple Sclerosis, Autoimmune diseases, hypothyroidism, neurological diseases, endocrine disorders, arthritis etc.
  • never treated with strong medications
  • never been operated on, has all body parts on its place, working as it should
  • healthy heart, lungs and cardiovascular system
  • no hearing problems and no vision problems and no problems with any of the senses

When the therapy is performed in clinical setup, donor is usually tested for STDs and for blood and intestinal infections and parasites. 
When doing the therapy at home,  without possibility to test donor, you simply chose the healthiest donor available.

 


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Teenager or adult donor:

You can also use feces from any healthy person, teenager or adult.

How to select a teenager or an adult donor?

Here are the basic requirements:

  • very healthy person, never been to a doctor, never needed a doctor
  • regular bowel movements, 1-2 per day
  • healthy color of feces (brown - brown yellow)
  • healthy smell of feces (not too strong smell, as it may indicate digestive problems)
  • healthy shape of feces, nicely formed, rounded, not too large, not too small
  • never treated with antibiotics,  or at least not treated with antibiotics during the last few years.
  • never been diagnosed with intestinal parasites, and never exhibited symptoms of intestinal parasites
  • average healthy weight, not obese, not underweight
  • never been diagnosed with sexually transmitted diseases.
  • physically active
  • not sexually promiscuous ( to decrease likeliness of being infected with any STD since the last test)
  • not practicing anal sex (to decrease chances of being infected with  intestinal parasites.)
  • never suffered from chronic acne, chronic peeling lips, hair loss, eczema, psoriasis, allergies, etc.
  • never suffered from chronic unpleasant body odor, bad breath
  • never suffered from chronic constipation or chronic diarrhea or travelers diarrhea
  • never suffered from any chronic disease or any other diseases
  • never treated with strong medications
  • never diagnosed with inflammatory bowel disease, irritable bowel syndrome, Crohn's disease, cancer, fibromyalgia, tumors, cysts, etc.
  • not addicted to junk foods, soft drinks, alcohol, narcotics, tobacco
  • not having a large number of amalgam fillings in his/her mouth
  • a donor that has never been treated with antibiotics is far better than a donor that has been  treated with antibiotics
  • if it is a woman, she should have a regular menstrual cycle. In that case, feces should not be taken during the days of  menstruation.
  • has not traveled to tropical countries with poor sanitation (to limit chances of a donor being unknowingly infected with intestinal parasites)
  • should test negative for sexually transmitted diseases like HIV, Chlamydia, syphilis, gonorrhea, herpes, hepatitis C, B, A, if possible, and if sexually active person.  Children of pre-sexual age may not need to be tested for STD.
  • should test negative for intestinal parasites, if possible to get tested. (blood test or stool test.)
  • should test negative for dangerous intestinal bacteria, if possible. (blood test or stool test)

 

Usually, a donor is a healthy family member, brother, sister, husband, wife, child, cousin, partner,  or a close friend.

 

You can not just ring on the door of your healthy neighbor Joe and ask him for poop.
"
- Hi Joe, how are you?  Beautiful day today!  You look really healthy!
- Hey, I need some of your poop.
- But, before you give it to me,  are you HIV negative?  Cause,  if you are positive, I don't really need it.

By the way, I have a few more questions for you:
- Are you promiscuous?  Do you practice safe sex? Do you practice anal sex by any chance?
- How long time since your last STD test?
- Have you used any antibiotics lately?
- Do you often have diarrhea? 
- Are you often constipated?  Are you often bloated ? Do you often fart?
- Do you scratch your anus often?
- Have you ever traveled to Brazil? Have you been swimming in Amazons?

- If the answer to any of those questions is Yes,  then just forget it ... I don't  need your poop, I will ask the girl next door.

"

So, it is obvious,  a donor has to be someone who will not call police after you ask him/her all of those and 100 of other similar questions ... :-)

 

 

Why are antibiotics so bad?

Antibiotics have a terrible side effect:  they alter bowel microbiota, changing it from healthy microbiota to unhealthy.

Antibiotics are the main cause or the main causative cofactor of chronic diseases like:  candidiasis, chronic diarrhea, constipation, chronic clostridium difficile infection, IBD, IBS, eczema, bad body odor, leaky gut syndrome, psoriasis, chronic acne, peeling lips, digestive problems, inflammatory bowel disease, Parkinson's disease, Multiple Sclerosis, etc.


FECES

You really need fresh feces (not older then 12 hours). You can also refrigerate fresh feces, and use it the next day, but the best is if you can get a hold of fresh feces.
You can also use a Tupperware box or any other similar plastic box to store the feces in your refrigerator.  But, fresh is the best.
So, be nice to your donor!

 


 

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