Stool Donor Demographics and Performance Indicators: Evidence From 223 Enrolled Stool Donors

Abstract

Introduction: Fecal Microbiota Transplantation (FMT) is an effective therapy for recurrent Clostridium difficile infection (CDI). Stool donation is essential for ensuring access to FMT, however, stool donors are difficult to recruit and retain due to rigorous screening processes. The ability to predict attributes of high-yield donors would help minimize costs and scale efficiency. Our study aimed to identify factors which could predict stool donor performance. Methods: Prospective stool donors completed a clinical questionnaire as part of a full clinical assessment to participate in a stool donation program. Donors who met inclusion criteria for participation were enrolled and had their stool collected for the duration of their participation in the program. For this analysis, donor-reported demographic and behavior data were compared to stool donation performance. Independent variables included: altruistic behavior, (donor-reported participation in volunteering or blood donation),health-seeking behavior, (taking probiotics, supplements, or adhering to special diet (e.g. vegetarian)), exercise behavior (# hours/ week doing physical exercise).The primary outcomes measured were donation frequency (# of donations per week), and numberof stool donations processed as treatments. Secondary analyses investigated prediction of average weight of samples, and % of samples rejected. Data were analyzed by multiple logistic regression models using R statistical package. Results: Overall 223 donors were enrolled between 13Nov2014 and 7May2018 in the stool donation program (Table 1). Overall, there were with no statistically significant indicators for donor performance of the clinical and behavioral variables assessed. There were no statistically significant predictors of frequency of stool donation, and no statistically significant predictors of number of stool donations processed as treatments (Model 2). Secondary analyses for predictors of weight, and percentage of samples rejected, were also not statistically significant. Conclusion: To our knowledge, this is the largest study assessing predictors of performance for enrolled stool donors. Our findings suggest that none of the factors we analyzed were discriminators for stool donor performance. These findings suggest that our donor population is homogenous with respect to predictors of their performance. Future analyses should seek to better understand donor motivation, as well as identifying potential barriers to donation.