New type of transplant at Spartanburg Medical Center
06/19/2014 10:30 AM
06/19/2014 10:33 AM
A type of transplant now offered at Spartanburg Medical Center does not involve organs or blood.
Instead, the procedure involves taking feces out of a healthy donor's intestines and putting it into a patient.
Dr. Gordon France, a gastroenterologist with Spartanburg Regional Healthcare System, said the donors' sample is homogenized into saline or milk. It is strained to make it as clean as possible, and then the fluid is squirted into the right side of the patient's colon via a colonoscopy.
The transplant is used to treat patients who have colon infections called Clostridium difficile, which affects more than half a million people and kills 14,000 Americans a year, according to the Mayo Clinic. Patients with severe cases can have diarrhea 10 to 15 times a day, fevers, nausea, dehydration, swollen abdomens, kidney failure and a loss of appetite.
“It hasn't really been studied, but a lot of literature suggests that (the procedure) is the most effective way to get rid of the infection once and for all,” France said.
For example, a 2013 study by the New England Journal of Medicine found that fecal transplants were nearly twice as effective as antibiotics in treating patients with recurring C. difficile.
“The problem with this infection is that most of the antibiotics that are given for it suppress the infection, but don't necessarily kill the infection,” France added. “What we want to do is to get rid of the infection and allow the patient's normal fecal flora (healthy bacteria living inside the intestines) to take back over.”
France called the infection a “real health issue.”
C. difficile bacteria are found throughout the environment — in soil, air, water, human and animal feces, and food products, such as processed meats. A small number of healthy people naturally carry the bacteria in their large intestine and don't have ill effects from the infection.
C. difficile infection is most commonly associated with health care, occurring in hospitals and other health care facilities where a much higher percentage of people carry the bacteria. Illness from C. difficile most commonly affects older adults in hospitals or in long-term care facilities and typically occurs after use of antibiotic medications, according to the Mayo Clinic.
France said the hospital is doing all it can to prevent and minimize the risk of transmission, but he still sees cases sporadically. It is estimated that 500,000 to 3 million cases of C. difficile occur annually in U.S. hospitals and long-term care facilities.
Stomach aches and abdominal cramps have plagued Julia Nettles since 2011, when she first contracted the infection.
“I have been so sick for so long,” Nettles said during a phone interview. “I have been on and off several antibiotics, but nothing was working. A lot of diarrhea, a lot of stomach aches, and it was hard to eat. It's affected my quality of life for a long time.”
Then France told her about the transplant. He said the procedure has been done for years in other parts of the country. Spartanburg Regional recently began offering it and has performed the procedure on four patients. He said three out of the four have shown positive results.
Right now, the transplant is offered as a last resort if antibiotics or other treatment options aren't working, France said.
France said the procedure is becoming more prevalent across the country. In 2013, the nation's first human stool bank opened in Massachusetts. The purpose of OpenBiome is to provide doctors with safe, inexpensive fecal material from screened donors to treat patients with C. difficile.
France said Spartanburg Regional doesn't get its feces from the stool bank. Donors here are typically family members of the patient, and they have to pay up to $1,000 out of pocket to be a donor.
Nettles said it seemed like the best option, and her dad volunteered to be the donor.
“I know people think it sounds so gross because of what it is,” she said. “And I understand that, but I look at it as any other kind of transplant.”
She had the procedure done a few weeks ago and now her stomach aches are gone.
“I am feeling better now,” she said. “It's really good news.”
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