Intestinal Microbiota Transplantation in Patients Undergoing Colon Resection

NCT06370884 | Recruiting Phase 1 FDA Drug

• 1 other identifier: SURG-2023-29833
• Study Type: interventional
• Target: 40
• Locations: 1 country
• Sites: 1

Brief Summary

This is a single-center, open-label study for safety and feasibility of IMT in patients undergoing colonic surgery. After consent, individuals of the ages of 18-75 with a history of diverticulitis or sigmoid colon cancer will be enrolled to have a feeding tube placed at the time of surgery and receive IMT solution on postoperative day 2-3 (at least 48 hours following IV antibiotics) with the subsequent removal of the feeding tube. Prior to administration of IMT, recipients will be screened for inclusion/exclusion criteria, interviewed for medical history and medications, and consented. Additionally, prior to undergoing IMT, baseline blood and fecal samples will be collected. The use of a nasogastric feeding tube has specifically been chosen over colonoscopic introduction of the IMT. This is because colonoscopy introduces increased intraluminal carbon dioxide and pressure as well as mechanical stress on the colon in the setting of a newly created bowel anastomosis, which may contribute to the potential risk of anastomotic disruption. The nasogastric feeding tube will be placed while the patient is under anesthesia under direct visualization to minimize any risk of bowel perforation, albeit very low. The study will specifically utilize a 10F 43" Corpak feeding tube (Halyard Health, Alpharetta, GA). Patients will be monitored while in-patient in person. Following discharge, they will undergo follow-up either by phone, video or in-person visit, or via online survey of symptoms and chronic medical conditions potentially related to IMT, beginning on the day following discharge through post-operative day 14, and then monthly up to 6 months post- IMT to screen for SAEs and AEs. Screening for SAEs and AEs will be done using a symptom questionnaire as well as by asking patients during our interview. Fecal samples will be collected from participants on months one, three and six post-IMT to assess for changes in recipient microbiome (engraftment kinetics).

Conditions

Recurrent Clostridioides Difficile Infection; Colonic Surgery

Outcome Measures

Primary Outcomes (2)

• Evaluate safety of IMT in patients undergoing colon surgery

  Collected via adverse event monitoring, to be reported as frequency, relatedness, expectedness, and severity of AEs/SAEs

  Day of surgery, post-op Day 1-14, Day30, Day60, Day90, Day120, Day150, Day180

• compare fecal microbiota prior to and after IMT

  Collected via stool sample collection, to be reported as sequenced microbial DNA profiles (alpha diversity, beta diversity)

  Day -60-0, Day of surgery, post-op Day1-3, Day14, Day30, Day90, Day180

Secondary Outcomes (11)

• Evaluate engraftment of donor microbiota

  Day -60-0, day of surgery, postoperative Day1-3, Day14

• Evaluate changes in circulating markers of inflammation: WBC

  Day -60-0, day of surgery, postoperative Day1-3, Day14, Day30, Day90, Day180

• Evaluate changes in circulating markers of inflammation: Hemoglobin

  Day -60-0, day of surgery, postoperative Day1-3, Day14, Day30, Day90, Day180

• Evaluate changes in circulating markers of inflammation: Platelets

  Day -60-0, day of surgery, postoperative Day1-3, Day14, Day30, Day90, Day180

• Evaluate changes in circulating markers of inflammation: Electrolytes

  Day -60-0, day of surgery, postoperative Day1-3, Day14, Day30, Day90, Day180

Study Arms (1)

IMT group

EXPERIMENTAL

individuals of the ages of 18-75 with a history of diverticulitis or sigmoid colon cancer will be enrolled to have a feeding tube placed at the time of surgery and receive either IMT solution

Drug: IMT

Interventions

IMT DRUG

a feeding tube placed at the time of surgery and receive IMT solution on postoperative day 2-3 (at least 48 hours following IV antibiotics) with the subsequent removal of the feeding tube.

IMT group

Eligibility Criteria

• Age: 18 Years - 75 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Able/willing to provide informed consent
• Between 18-75 years of age
• Undergoing surgery for a history of diverticulitis or sigmoid colon cancer.
• Able to provide fecal samples
• Stated willingness to comply with all study procedures and availability for the duration of trial to follow-up by telephone, in-person, email, and/or video visits or correspondence

You may not qualify if:

• Any history of inflammatory bowel disease
• Pregnancy or breastfeeding. A pregnancy test will be obtained from females of child- bearing potential on the proposed day of IMT (prior to the receipt of IMT). Patients with a positive pregnancy test will be excluded. A negative result will be required for subjects who are females of child-bearing potential to receive IMT treatment.
• Life expectancy of \< 6 months
• Presence of ileostomy or colostomy
• Known history of inflammatory bowel disease (Crohn's, Ulcerative Colitis)
• Patients on immunosuppressants (calcineurin inhibitors, prednisone ≥ 20 mg/day, methotrexate, azathioprine, immunosuppressive biologics, JAK inhibitors)
• Patients with neutropenia (an absolute neutrophil count \< 0.5 x 109 cells/L) obtained on a complete blood count with differential at screening.
• History of solid organ or bone marrow transplant.
• Anticipated recurrent antibiotic use (e.g., patients with frequent urinary tract infections or sinusitis).
• History of severe anaphylactic food allergy.
• History of celiac disease.
• Patients receiving cancer chemotherapy, immunotherapy, or radiation.

Sponsors & Collaborators

• University of Minnesota: lead

Study Sites (1)

University of Minnesota

Minneapolis, Minnesota, 55414, United States

RECRUITING

MeSH Terms

Conditions

Clostridium Infections

Condition Hierarchy (Ancestors)

Gram-Positive Bacterial Infections; Bacterial Infections; Bacterial Infections and Mycoses; Infections

Study Officials

• Cyrus Jahansouz, MD

  University of Minnesota

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Kathryn Vera

CONTACT

612-625-5018; giero002@umn.edu

Study Design

• Study Type: interventional
• Phase: phase 1
• Allocation: NA
• Masking: NONE
• Purpose: OTHER
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: This is a phase 1 pilot clinical trial that will evaluate the initial safety and feasibility of intestinal microbiota transplantation (IMT) in patients undergoing colon resection.

Study Record Dates

• First Submitted: March 4, 2024
• First Posted: April 17, 2024
• Study Start: February 1, 2024
• Primary Completion: April 1, 2026
• Study Completion (Estimated): August 1, 2026
• Last Updated: October 9, 2025

Record last verified: 2025-10

Locations

US (1)