In 2011, Carolyn Edelstein founded the microbiota organisation OpenBiome after her cousin gave himself an FMT on his own, in his bathroom, with faeces donated by his housemate. Such DIY treatments can sometimes be risky because there’s no way of knowing what lives in the donor’s guts, and if it matches the recipient’s gut. The need for rigorous testing of donor microbiota was underlined after a rare form of drug-resistant E. coli was found to have been transferred to two patients, one of whom subsequently died, during a clinical trial at a hospital in the US. But despite this there are still several accounts of DIY treatments being a widespread trend.
What Edelstein’s organisation created in response is “like a blood bank, but for stool”, she says. In a laboratory in Cambridge, Massachusetts, scientists clad in poop-emoji-print lab coats prepare solutions of liquefied donor stools and store them in labelled vials in massive freezers. The advantage of having so many stool samples in one place is that, “we can be a lot more rigorous than you can be when you’re doing a single donor per patient”, says Edelstein.