Guidelines for reporting on animal fecal transplantation (GRAFT) studies: recommendations from a systematic review of murine transplantation protocols

Gut Microbes. 2021 Jan-Dec;13(1):1979878. doi: 10.1080/19490976.2021.1979878.

Abstract

Fecal microbiota transplant (FMT) is a powerful tool used to connect changes in gut microbial composition with a variety of disease states and pathologies. While FMT enables potential causal relationships to be identified, the experimental details reported in preclinical FMT protocols are highly inconsistent and/or incomplete. This limitation reflects a current lack of authoritative guidance on reporting standards that would facilitate replication efforts and ultimately reproducible science. We therefore systematically reviewed all FMT protocols used in mouse models with the goal of formulating recommendations on the reporting of preclinical FMT protocols. Search strategies were applied across three databases (PubMed, EMBASE, and Ovid Medline) until June 30, 2020. Data related to donor attributes, stool collection, processing/storage, recipient preparation, administration, and quality control were extracted. A total of 1753 papers were identified, with 241 identified for data extraction and analysis. Of the papers included, 92.5% reported a positive outcome with FMT intervention. However, the vast majority of studies failed to address core methodological aspects including the use of anaerobic conditions (91.7% of papers lacked information), storage (49.4%), homogenization (33.6%), concentration (31.5%), volume (19.9%) and administration route (5.3%). To address these reporting limitations, we developed theGuidelines for Reporting Animal Fecal Transplant (GRAFT) that guide reporting standards for preclinical FMT. The GRAFT recommendations will enable robust reporting of preclinical FMT design, and facilitate high-quality peer review, improving the rigor and translation of knowledge gained through preclinical FMT studies.

Keywords: FMT; Fecal microbiome transplantation; guidelines; methodology; replication; reporting guidelines; reproducibility.

Publication types

  • Guideline
  • Research Support, Non-U.S. Gov't
  • Systematic Review

MeSH terms

  • Animals
  • Clostridioides difficile / genetics
  • Clostridioides difficile / physiology
  • Clostridium Infections / microbiology
  • Clostridium Infections / therapy*
  • Disease Models, Animal
  • Fecal Microbiota Transplantation / methods
  • Fecal Microbiota Transplantation / standards*
  • Gastrointestinal Microbiome
  • Humans
  • Mice

Associated data

  • figshare/10.25909/14978817.v2

Grants and funding

KRS, GHA, CBS and JS are in receipt of an Australian Government Research Training Program Scholarship. KRS is in receipt of a Lion’s Medical Research Foundation Scholarship. CBS is in receipt of the Doctor Chun Chung Wong and Madam So Sau Lam Memorial Postgraduate Cancer Research Scholarship. Hannah Wardill is a National Health and Medical Research Council CJ Martin Biomedical Research Fellow. Lions Medical Research Foundation; Australian Government Research Training Program Stipend; The Doctor Chun Chung Wong and Madam So Sau Lam Memorial Postgraduate Cancer Research Scholarship; Australian Government Research Training Program Stipend; Australian Government Research Training Program Stipend; Australian Government Research Training Program Stipend.