Space & Innovation

Frozen Poop as Good as Fresh Poop for Treatment

Frozen-poop transplants have a number of advantages over fresh-poop transplants for use in patients with C. difficile.

For patients with the difficult-to-treat intestinal infection caused by a bacterium called Clostridium difficile, a "poop transplant" that uses frozen poop may be as effective as one that uses fresh poop, a new study suggests.

Frozen-poop transplants have a number of advantages over fresh-poop transplants for use in patients with C. difficile, said study author Dr. Christine Lee, an infectious-disease specialist at McMaster University in Ontario, Canada.

In the study, researchers looked at more than 200 adults who had C. difficile infections that were recurrent or unresponsive to other types of treatment. The researchers found that the percentage of patients who recovered from their infection without relapsing about three months after receiving frozen fecal transplants from healthy donors was comparable to the percentage of those who recovered after receiving fresh fecal transplants. [5 Things Your Poop Says About Your Health]

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The people who donate the fecal material that is used for such transplants have to undergo extensive medical testing, including blood and stool testing, and that can take one to two weeks, Lee told Live Science. But if the material can be frozen and stored, it can be available for use right away when a patient needs it, even in facilities that don't have the labs needed to prepare fecal material for transplants, she said.

Infections with C. difficile are notoriously difficult to treat, and patients have high rates of recurrences even if their symptoms initially improve. The bacterium is one of the most common causes of infection of the colon, and more than 60 percent of patients who have been infected with it experience further episodes, researchers estimate.

In the new study, 114 adults with recurrent or treatment-resistant C. difficile infections received frozen-poop transplants, and 118 adults received fresh-poop transplants, via enemas. Some in each group also received antibiotics.

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Among the patients who received frozen transplants and antibiotics, 75 percent experienced a resolution of the main symptom of their infection (diarrhea) after 13 weeks, compared with 70 percent of those who received fresh-poop transplants and antibiotics.

Among the patients who did not receive antibiotics, 83.5 percent of the patients who received frozen transplants experienced a resolution of their diarrhea after 13 weeks, compared with 85 percent of those who received fresh-poop transplants.

Previous research has suggested that frozen-poop transplants could be as effective as fresh ones, but that research was conducted in a much smaller number of participants than in the new study, Lee said. Therefore, the data from the new study "is more robust," she told Live Science.

3-D Printed Body Parts, Finally!

Now, the researchers are planning to test the effectiveness of transplants involving poop that has been frozen and dried, Lee said. One advantage of this technique would be a longer shelf life and the possibility of sending the material to any location in the world, she said.

The new study was published today (Jan. 12) in the journal JAMA.

Originally published on Live Science.

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When physicians run out of treatment options they look to a nascent field known as bioengineering. Specialized scientists apply engineering principles to biological systems, opening up the possibility of creating new human tissue, organs, blood and even corneas such as the one shown here. Waiting lists for organ transplants continue to be lengthy so the race to save lives with bioengineered body parts is on. Here’s a look at some of the most notable achievements in recent years.

Skin

Producing small amounts of artificial skin to graft on patients and use for toxicity testing has been possible for years. Human skin cells are cultivated in the lab and then embedded in a collagen scaffold. In 2011, the Fraunhofer Institute for Interfacial Engineering and Biotechnology introduced a system that can rapidly manufacture two-layer artificial skin models. Their Tissue Factory has the capacity to make 5,000 skin sheets in a month.

Ear

Reproducing 3-D biological structures, particularly the complex human ear, presents significant challenges for bioengineers. A team at Princeton University led by mechanical and aerospace engineering associate professor Michael McAlpine used 3-D printing technology to make a functional ear from calf cells and electronic materials. The ear that debuted in May 2013 is no mere replacement -- it can pick up radio frequencies well beyond the range that human ears normally detect.

Bladder

Surgeon Anthony Atala directs the Wake Forest Institute for Regenerative Medicine and is known for growing new human cells, tissues and organs -- particularly ones that advance urology. Atala and his team’s bioengineered bladders succeeded in clinical trials. The bladders were constructed from patients’ cells that were grown over two months on a biodegradable scaffold and then implanted. Patients included children with spina bifida who risked kidney failure. It’s been several years since then and the results are positive. “These constructs appear to be doing well as patients get older and grow,” Atala told the NIH Record.

Blood Vessels

Being able to make blood vessels in the lab from a patient’s own cells could mean better treatments for cardiovascular disease, kidney disease and diabetes. In 2011, the head of California-based Cytograft Tissue Engineering reported progress in a study where three end-stage kidney disease patients were implanted with blood vessels bioengineered in the lab. After eight months the grafts continued to work well, easing access to dialysis. Then this month a team at Massachusetts General Hospital found a way to encourage stem-like cells to develop into vascular precursor cells, a key step on the way to becoming blood vessel cells. They generated long-lasting blood vessels in living mice.

Heart

Artificial heart devices have been surgically implanted since the 1980s, but no device has been able to replace the human heart as effectively as a healthy biological one. After all, a human heart pumps 35 million times in a single year. Recently scientists have made advances in adding more biological material to artificial heart devices. In May the French company Carmat prepared to test an artificial device containing cow heart tissue. At Massachusetts General Hospital, surgeon Harald C. Ott and his team are working on a bioartificial heart scaffold while MIT researchers recently printed functional heart tissue from rodent cells.

Liver

Bioengineers are working on it, but the liver is one of the largest, most challenging organs to recreate. In 2010 bioengineers at Wake Forest University Baptist Medical Center grew miniature livers in the lab using decellularized animal livers for the structure and human cells. This month, a team from the Yokohama City University Graduate School of Medicine published results of a study where they reprogrammed human adult skin cells, added other cell types, and got them to grow into early-stage liver “buds.” Currently the scientists can produce about 100 of them, but the study’s lead author Takanori Takebe told the Wall Street Journal that even a partial liver would require tens of thousands.

Trachea

In April, after an international team of surgeons spent nine hours operating on her at Children's Hospital of Illinois in Peoria, 32-month old Hannah Warren became the youngest patient to ever receive a bioengineered organ. Scientists had made a windpipe for her using her own bone marrow cells. Born without a trachea, she needed help breathing, eating, drinking and talking. Harvard Bioscience created the custom scaffold and bioreactor for the experimental procedure. Sadly Hannah died on July 7 due to complications from a more recent surgery on her esophagus. Despite the high risks, bioengineers say they will continue to move ahead.

Back Discs

When a ruptured or degenerating disc causes chronic back pain, treatment is limited. At worst, patients undergo surgery to fuse vertebrae together and then have limited flexibility. Over the past several years artificial discs have emerged as an alternative, but they can wear out as they work. In 2011, a research team from Cornell University bioengineered implants using gel and collagen seeded with rat cells that were then successfully placed into rat spines. This summer Duke bioengineers took things further, coming up with a gel mixture they think can help regenerate tissue when injected into the space between discs.

Intestines

Little by little, bioengineered intestines are being grown in the lab to diagnose digestive disorders and to help patients born without a piece of intestine. In 2011, Cornell biological and environmental engineering assistant professor John March began collaborating with Pittsburgh-based pediatric surgeon David Hackam on a small artificial intestine using collagen and stem cells. Then last year in Switzerland, EPFL professor Martin Gijs led a project in the Laboratory of Microsystems to create a miniature intestinal wall from cultured epithelial cells and electronics called NutriChip to identify foods that cause inflammation. Scientists at Harvard’s Wyss Institute also made a “gut-on-a chip” to mimic the real thing using intestinal cells in a tiny silicon polymer device.

Kidney

One in 10 American adults will have some level of chronic kidney disease, according to the Centers for Disease Control and Prevention. Currently around 600,000 patients in the U.S. have chronic kidney failure. Most rely on dialysis while a fraction of them actually get transplants. Scientists from the University of California, San Francisco are on a mission to create a sophisticated artificial kidney device made with human kidney cells, silicon nanofilters and powered by blood pressure. The project, led by UCSF nephrologist William Fissell and bioengineering professor Shuvo Roy, aims to begin testing the kidney device in 2017.