Editorial
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. May 27, 2024; 16(5): 678-683
Published online May 27, 2024. doi: 10.4254/wjh.v16.i5.678
Fecal microbiota transplantation in the treatment of hepatic encephalopathy: A perspective
Arghya Samanta, Moinak Sen Sarma
Arghya Samanta, Moinak Sen Sarma, Department of Pediatric Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow 226014, India
Author contributions: Samanta A did the literature review and wrote the original manuscript; Sen Sarma M did critical analysis, reviewed and revised the manuscript; All authors approved the final version of the manuscript.
Conflict-of-interest statement: All authors declare no conflict of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Moinak Sen Sarma, MBBS, MD, Adjunct Associate Professor, Doctor, Department of Pediatric Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareli Road, Lucknow 226014, India. moinaksen@yahoo.com
Received: January 23, 2024
Revised: March 6, 2024
Accepted: April 16, 2024
Published online: May 27, 2024
Processing time: 119 Days and 23.8 Hours
Abstract

Due to its complex pathogenesis, treatment of hepatic encephalopathy (HE) continues to be a therapeutic challenge. Of late, gut microbiome has garnered much attention for its role in the pathogenesis of various gastrointestinal and liver diseases and its potential therapeutic use. New evidence suggests that gut microbiota plays a significant role in cerebral homeostasis. Alteration in the gut microbiota has been documented in patients with HE in a number of clinical and experimental studies. Research on gut dysbiosis in patients with HE has opened newer therapeutic avenues in the form of probiotics, prebiotics and the latest fecal microbiota transplantation (FMT). Recent studies have shown that FMT is safe and could be effective in improving outcomes in advanced liver disease patients presenting with HE. However, questions over the appropriate dose, duration and route of administration for best treatment outcome remains unsettled.

Keywords: Fecal microbiota; Dysbiosis; Hepatic encephalopathy; Cirrhosis

Core Tip: Hepatic encephalopathy (HE) remains one of the most dreaded and difficult-to-treat complications in patients with cirrhosis. Alteration in the number and diversity of microorganisms in the human intestinal tract appears to have profound effect in the pathophysiology of HE in cirrhotic patients. Targeting gut dysbiosis by fecal microbiota transplantation is a promising therapeutic modality.