Faecal Microbiota Transplant (FMT) service

About the service

• Since 2014, Imperial College Healthcare NHS Trust (ICHNT) has run a faecal microbiota transplant (FMT) service in conjunction with Imperial College London (ICL). It is currently one of only four UK centres to offer this service at any significant scale.
• FMT is regulated within the UK by the MHRA, and is classified as an unlicensed medicine.
• FMT is primarily considered as treatment for patients with recurrent Clostridioides difficile infection (CDI), in line with ICHNT policy.
• FMT is also considered in highly selective circumstances as a ‘compassionate use’ treatment for patients with certain non-CDI conditions, in line with current national FMT guidelines*.
• The service is co-ordinated between the Trust and ICL.
• There are also a number of active clinical trials ongoing at ICL for which FMT is being given for different indications.
• The FMT service primarily treats ICHNT patients, although access to the service from external Trusts may rarely be considered through a ‘treat and transfer’ arrangement (i.e. transfer over from another Trust for treatment, before transferring back to the referring hospital).

FMT product

• ICHNT primarily provides a faecal slurry that is prepared from donors who are screened within the Trust. This is usually administered via nasogastric tube, but has also been administered colonoscopically. Other routes of administration may be considered based upon the clinical scenario.
• Options are being explored for provision of a capsulised product.

Operation of service and gaining potential access to FMT

• All cases that may be potentially eligible for treatment in ICHNT for FMT are first discussed in a virtual multi-disciplinary group, with feedback given to the referrer regarding suitability, and a decision made regarding appropriateness of FMT.
• Referrals to the virtual group may be made via: imperial.FMTvirtualgroup@nhs.net
• Where FMT is felt appropriate, the virtual group will support the referrer with regards to getting access to the product.

Any questions

The virtual group will be happy to provide any further advice which you might need: imperial.FMTvirtualgroup@nhs.net.

Terms of reference

Our terms of reference can be found here.

*Gut 2024; 148:189-219. The use of faecal microbiota transplant as treatment for recurrent or refractory Clostridioides difficile infection and other potential indications: second edition of joint British Society of Gastroenterology (BSG) and Healthcare Infection Society (HIS) guidelines.