For individual patients, donor microbiota engraftment after FMT is dependent on patient and donor microbiota characteristics and clinical modalities of the FMT treatment
(A) Forest plot showing the relevance of microbiota and clinical parameters for donor-derived strain fractions in post-FMT patients in the FMT meta-cohort, as determined with a generalized linear mixed model. The model is based on data from 254 clinical FMT cases, including samples from post-FMT patients (samples n = 801; FRI = 12, ALM = 24, ERE = 51, CHA = 105, BOR = 15, OSU = 112, ZAR = 146, BOU = 30, GOR = 58, KAa = 95, KAb = 63, XAV = 33, PAU = 13, HUT = 44), their respective donors (n = 140), and earliest available pre-FMT samples (n = 254).
(B) Simulations with this model to determine the marginal effects of α-diversity on donor strain engraftment, i.e., using real values in combination with the minimum or maximum Shannon index detected in any donor in the FMT cohort (min/max within 95% confidence intervals), indicate a disproportionate impact of high-α-diversity donors on low-α-diversity FMT recipients.
(C) Similar simulations predict independent marginal effects of ABx and lavage pretreatment on donor strain engraftment. Shaded areas and bars denote the 95% confidence intervals (Wald). Asterisks denote significance thresholds: ∗p ≤ 0.01, ∗∗p ≤ 0.001, ∗∗∗p ≤ 0.0001.