IDDF2022-ABS-0274 Comparative study of the efficacy and safety of washed microbiota transplantation delivery methods for ulcerative colitis in different age groups

Background Washed microbiota transplantation (WMT) is a promising methodology have been applied in China since 2016, with the goal of delivering a precise enriched dose of fecal microbiota while reducing adverse events. We aimed to identify clinical factors that affect WMT response using two delivery methods in ulcerative colitis (UC), considering different age groups. Methods We retrospectively analyzed the evolution of a total of 200 UC patients who underwent a protocol of multiple transfusions of WMT delivered through Mid-gut or colonic transendoscopic enteral tubing (TET). Within a decision-making system based on data envelopment analysis (DEA) applied to a set of inputs and outputs. Inputs included UC characteristics, such as severity, extension, and concomitant medications and outputs included both patients’ responses and WMT-related adverse events (AEs). Using DEA as a clustering technique, we classified patients based on the relative efficiency performance according to the route of delivering WMT to identify specific variables that contribute to WMT response in different age groups. Results Of 200 patients, 42.5% achieved clinical remission, 40% had clinical improvement, and 17.5% failed to achieve response, with 15.5% experienced related adverse events. Colonic TET was the main method for WMT administration in UC patients who needed multiple WMTs in all age groups. After implementing DEA to categorize patients according to the route of delivering WMT. We found that patients who received WMT via colonic TET route showed higher suboptimal performances for higher Mayo clinic score in the middle age and the elevated CRP in both groups except the elderly. The elderly group, who totally received WMT just via colonic TET, showed good performance across all sets of input variables. IDDF2022-ABS-0274 Figure 1, IDDF2022-ABS-0274 Figure 2, IDDF2022-ABS-0274 Figure 3: The performance of patients with age groups {<40, 40–65, >65} retrospectively, across a set of input variables after implementing DEA to categorize patients according to the route of delivering WMT. Higher values represent relatively worse performance. Conclusions WMT Via Mid-gut and colonic TET appear to be a safe and promising WMT delivery method for UC patients, taking into consideration the clinical severity of UC, especially in younger age.