Ma L, Zhang MH, Xu YF, Hao YX, Niu XX, Li Y, Xing HC. Fecal microbiota transplantation: A promising treatment strategy for chronic liver disease. World J Gastroenterol 2025; 31(28): 105089 [DOI: 10.3748/wjg.v31.i28.105089]
Corresponding Author of This Article
Hui-Chun Xing, MD, PhD, Chief Physician, Professor, Center of Liver Diseases Division 3, Beijing Ditan Hospital, Capital Medical University, No. 8 Jingshun East Street, Chaoyang District, Beijing 100015, China. hchxing@sohu.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Jul 28, 2025; 31(28): 105089 Published online Jul 28, 2025. doi: 10.3748/wjg.v31.i28.105089
Fecal microbiota transplantation: A promising treatment strategy for chronic liver disease
Lei Ma, Meng-Han Zhang, Yi-Fan Xu, Yan-Xu Hao, Xuan-Xuan Niu, Yan Li, Hui-Chun Xing
Lei Ma, Meng-Han Zhang, Yi-Fan Xu, Yan-Xu Hao, Xuan-Xuan Niu, Yan Li, Hui-Chun Xing, Center of Liver Diseases Division 3, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China
Hui-Chun Xing, Center of Liver Diseases Division 3, Peking University Ditan Teaching Hospital, Beijing 100015, China
Author contributions: Ma L performed the data analysis and drafted the manuscript; Hao YX, Niu XX, and Li Y analyzed and interpreted the data; Zhang MH and Xu YF revised the manuscript critically for important intellectual content; Xing HC made substantial contributions to conception and design, and finally approved the version to be published.
Supported by National Key R&D Program of China, No. 2022YFC2304505 and No. 2021YFC2301801; the Beijing Municipal of Science and Technology Major Project, No. Z221100007422002; the Capital Funds for Health Improvement and Research, No. CFH-2024-1-2181; and Beijing Igandan Foundation, No. iGandanF-1082023-GSH011.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
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: Hui-Chun Xing, MD, PhD, Chief Physician, Professor, Center of Liver Diseases Division 3, Beijing Ditan Hospital, Capital Medical University, No. 8 Jingshun East Street, Chaoyang District, Beijing 100015, China. hchxing@sohu.com
Received: January 11, 2025 Revised: April 27, 2025 Accepted: July 2, 2025 Published online: July 28, 2025 Processing time: 194 Days and 19 Hours
Abstract
Chronic liver disease has become a global health crisis, with increasing incidence and mortality rates placing a substantial burden on healthcare systems worldwide. A key factor in the progression of chronic liver disease is intestinal microbiota dysbiosis, which influences liver function via the intricate liver-gut axis. This axis plays a central role in various physiological processes, and disruptions in microbial composition can exacerbate liver pathology. Fecal microbiota transplantation (FMT) has emerged as a promising therapeutic strategy, with the potential to restore the composition and metabolic functions of the intestinal microbiota. Supported by encouraging findings from clinical trials and animal studies, FMT has demonstrated therapeutic benefits, including improvements in clinical symptoms, objective indicators, and long-term prognosis. These benefits encompass reductions in hepatic lipid deposition and inflammation, mitigation of complications in advanced liver disease, promotion of hepatitis B e antigen seroconversion, and enhancement of cognitive function. Although clinical evidence remains preliminary, current data underscore the transformative potential of FMT in managing chronic liver diseases. Nonetheless, challenges persist, including the need for standardized procedures, variability among donors, potential risks, and concerns regarding long-term safety. This review provides a comprehensive evaluation of the current literature on the efficacy and safety of FMT, while exploring future research directions to expand its application in liver disease management.
Core Tip: Fecal microbiota transplantation shows significant potential in treating chronic liver diseases by improving liver inflammation, biomarkers, lipid metabolism, and cognitive function. It works through the liver-gut axis, restoring intestinal microbiota balance. Despite promising results, challenges remain in donor selection, standard treatment protocols, and long-term safety. Ongoing clinical trials and further research are needed to refine protocols and establish standardized approaches for optimal efficacy and safety in managing chronic liver diseases.
