Antibiotic-Associated Disruption of Microbiota Composition and Function in Cirrhosis is Restored by Fecal Transplant

Recurrent HE is the leading cause of readmissions in cirrhotic patients in North America and despite medications such as lactulose and rifaximin; there continues to be a substantial proportion of patient who continue to recur. These recurrences can lead to irreversible neuro-cognitive injury, impaired daily functionality and burdening of the caregivers and high healthcare expenditure We demonstrated in this randomized trial that the use of FMT guided through a precision medicine approach using a single donor is safe, well-tolerated and is associated with clinical improvement in hospitalizations and reversal of the impact of broad-spectrum antibiotic use in cirrhotic patients with recurrent hepatic encephalopathy not responsive to lactulose and rifaximin.