Evidence-based approach to management of hepatic encephalopathy in adults

Table 1 Table summarizing characteristics of all studies involving fecal microbiota transplant in cirrhotic patients

Ref.	Study		Intervention	Route of FMT administration	n	Mean MELD score	Follow-up
Bajaj et al[29], 2019	Phase I	Treatment arm	FMT + SOC	Enema	10	12.5	5 mo
		Control arm	SOC		10	12.5	5 mo
Bajaj et al[28], 2017	Phase I	Treatment arm	FMT	Enema	10	13.2	5 mo
		Control arm	SOC		10	12	5 mo
Woodhouse et al[33], 2019	Phase III	Treatment arm	FMT + Lactulose	NJ tube	13	12.88	3 mo
		Control arm	SOC		5	12.88	3 mo
Bloom et al[81], 2019	Phase II	Treatment arm	FMT	Oral	7	13.9	1 mo
		Control arm	SOC		3	NA	1 mo
Mehta et al[30], 2018	Case series		FMT	Colonoscopy	10	18	20 d
Kao et al[32], 2016	Case report		FMT	Colonoscopy	1	10	7 d

FMT: Fecal microbiota transplant; SOC: Standard of care; MELD: Model for end-stage liver disease.

Table 2 Table summarizing the findings of all studies involving fecal microbiota transplant in cirrhotic patients

Ref.	MELD or MELD delta (last visit-baseline)	SAE	No. of hospitalized patients	Ammonia level (mean µ/dL )	HE episodes	Cognitive assessment (s): Encephaloapp stroop test (low is good) (t = time, Δt: Change in time)	Cognitive assessment (points): PHES score (high is good) (p = points, Δp: Change in points)
Bajaj et al[29], 2019	2.8 + (-4.5)	1	0 at median 1 yr	NA	0 at median 1 yr	Day 0: 245; day 20: 200; t > 1 yr: 225	Day 0: -7; day 20: -4; P > 1 yr: -6
	2.78 + (-4.7)	3	10 at median 1 yr	NA	1.5 at median 1 yr	Day 0: 260; day 20: 250; t > 1 yr: 250	Day 0: -8; day 20: -8; P > 1 yr: -11
Bajaj et al[28], 2017	0.1 + (-2)	2	1	NA	0 at 0.4 yr	Day 0: 247; day 0-20: 29.1 ± 27.9	Day 0: -7.4; day 0-20: (-3.1) ± (-2.1)
	-0.2 + (-2.7)	8	9	NA	6 at 0.4 yr	Day 0: 282; day 0-20: (-43.5) ± (-95.7)	Day 0: -8.6; day 0-20: 0.0 ± 3.1
Woodhouse et al[33], 2019	No significant change	4	4 at day 30	Day 0: 71; day 30: 51	NA	NA	NA
	No significant change	1	1 at day 30	Day 0: 54; day 30: 73	NA	NA	NA
Bloom et al[81], 2019	14.3 ± 3.3	1	NA	No significant change	NA	Day 0: 56; day 30: 22	Day 7: 2.6; day 30: 3.9
	NA	NA	NA	No significant change	NA	NA	NA
Mehta et al[30], 2018	15	4	2 by 20 wk	Day 0: 96; day 20: 74	3 by 20 wk	NA	NA
Kao et al[32], 2016	NA	0	1	Day 0: 75; day 20: 45	0	Day 0: 250.9; day 7: 203.4	NA

MELD: Model for end-stage liver disease; HE: Hepatic encephalopathy; NA: Not available.