Patients with recurrent episodes of hepatic encephalopathy experience cognitive improvements and significantly fewer hospitalizations after fecal microbiota transplantation than after standard care, according to a phase 1 study designed to evaluate the safety of this treatment.

Fecal microbiota transplantation “is a safe procedure in this population with advanced hepatic encephalopathy,” said Jasmohan Bajaj, MD, from Virginia Commonwealth University in Richmond. “We were pleasantly surprised when we saw efficacy.”

Recurrent episodes of hepatic encephalopathy are a leading cause of hospital admission, and can occur despite treatment with lactulose and rifaximin. The condition is characterized by personality changes, intellectual impairment, and a depressed level of consciousness.

“This is the first randomized trial to show that fecal transplantation may be of benefit to patients with hepatic encephalopathy,” Tom Karlsen, MD, PhD, from the Department of Transplantation Medicine at Oslo University Hospital Rikshospitalet in Norway, who is secretary general of the European Association for the Study of the Liver (EASL), said in a statement.

See the review on Medscape here (free registration).