Flora Transplant

WHAT IS TOTAL GASTROINTESTINAL FLORA TRANSPLANTATION ?

Flora Transplantation: To answer this question, we first need to describe what FLORA is.

WHAT IS FLORA ?

Certain parts of the human body are inhabited by microorganisms which peacefully live with us, do not harm us, contribute to the vital functions of the region in which they live, cause health problems when not present, whose functions cannot be compensated in any other way, which constantly renew themselves, whose diversity increases under favorable living conditions, and whose number and biodiversity decrease in some unfavorable conditions. Their generic name is FLORA.

What is at stake is the flora of the digestive tract. The digestive system refers to the tract from the mouth to the anus. The digestive system is home to members of the flora throughout the mouth, throat, larynx, esophagus, stomach, small and large intestine, with unique functions at each site. Those are specific to the site they occupy and cannot inhabit or live in other sites.

The number of flora bacteria identified in the human digestive tract to date is 1054. Flora diversity is among the most important factors affecting quality of life.

HOW MANY TYPES OF FLORA BACTERIA DO HUMANS HARBOR IN THE ENTIRE DIGESTIVE SYSTEM ?

The most important factor in this is the environmental conditions. Whereas the diversity of flora in those living in large metropolitan areas is as low as 50-60, this figure tends to increase in rural areas. In Turkey, people on average have a flora diversity of around 100 to 110 species throughout the entire digestive tract.

A high level of biodiversity of the digestive tract flora is directly proportional to a healthy, high quality and long life. Our flora members have diverse functions and are therefore indispensable for our health.

WHAT IS THE FUNCTION OF FLORA ? WHY DOES IT MATTER TO US ?

Each part of our body has its own flora, which are the most crucial structures that fight against pathogens coming from outside. In cases where the flora of a given site is reduced, destroyed or extinct, the site gets invaded by pathogenic microorganisms. A disturbed flora in our throat, for example, leads to chronic tonsillitis and chronic pharyngitis. A disturbed oral flora, on the other hand, may result in bad breath, dental caries, canker sores and dry mouth. The flora of the digestive tract is of critical importance in the formation of a gel-like secretion called mucus, which coats the entire lining of the digestive tract, in the site they inhabit. In the absence of mucus, what we eat and drink as well as all the secretions of the digestive system come into direct contact with the surface of the digestive system (mucosa) and cause erosion in the parts they come into contact with. The flora is indispensable for the acid-base balance, enzymatic function, synthesis function and digestive activities of the site they inhabit. Without flora, these functions get impaired. Any disruption of the flora in any given site not only disrupts the function of that site, but also causes disruptions in the functions ahead and behind it.

WHAT ARE THE FACTORS THAT AFFECT THE FORMATION OF FLORA ?

• The flora of the people in the region of birth and residence
• Cultural habits (dietary habits, cohabitation, household size)
• Number of people in close contact
• Breast milk intake
• Past illnesses
• Treatments received (antibiotics, chemotherapy, surgery)
• Genetic inheritance
• Environmental conditions (village, town, city, metropolis, etc.)
• Nutritional adequacy
• Mental health
• Industrial pollutants, radiation, toxins, agricultural chemicals

IS THE FLORA OF EVERY HUMAN BEING THE SAME ?

No, it isn’t. Each human being’s flora is influenced by numerous factors. Like a fingerprint, each person has their own flora.

The process of acquiring flora starts from the moment we are born and lasts a lifetime. The diversity of flora may increase or decrease due to various factors such as infancy, childhood, adolescence, fertility, pregnancy, breastfeeding, stresses, treatments, diseases, nutrition, etc. Yet, in all people, the period between the ages of 20 and 30 is when the flora is at its highest quality and diversity. The biodiversity of flora decreases with aging and predisposes to many diseases.

WHAT HAPPENS WITHOUT FLORA ?

It is impossible to live without flora.

WHAT IS A FLORA TRANSPLANT ?

Flora transplantation is the process consisting of collecting flora samples from at least one healthy FLORA DONOR under general anesthesia through endoscopy and colonoscopy from approximately 30 different anatomical regions of the digestive system, with each region being washed with serums suitable for its own characteristics and aspirated back, subjecting these samples to some series of specific procedures, and then transferring them endoscopically and colonoscopically to the equivalent anatomical regions of the patient under general anesthesia.

DOES BEING A FLORA DONOR POSE ANY HARM TO THE DONOR ?

No, it doesn’t. The flora collected from the FLORA DONOR is a sample flora collected endoscopically and colonoscopically by washing approximately 30 different regions with liquids specially prepared for each region and taking back a part of the washing water, so as not to harm the digestive system, the body, and the flora. It is like picking the fruit of an apricot tree and growing new apricot trees with it. So, it’s kind of like collecting the seed. The flora sample collected is not even one thousandth of the flora present. Besides, our flora is a living and dynamic structure that is renewed many times a day with the old ones being naturally excreted.

Donating flora does not cause tissue or organ loss in the flora donor, does not impair the donor’s bodily functions, and NEVER causes permanent or temporary harm to the donor. A healthy donor can donate flora many times over without losing anything from his/her body.

HOW MANY DONORS ARE NEEDED FOR FLORA TRANSPLANTATION ?

At least one healthy donor is needed. However, transplants from multiple donors intended for increasing biodiversity have an increased success rate.

WHAT ARE THE ELIGIBILITY CRITERIA FOR DONATING FLORA ?

To be eligible for donation, donors are required to meet the requirements set out for the periods in the table below.

HOW IS IT DECIDED WHETHER A FLORA DONOR’S FLORA IS OF GOOD QUALITY OR NOT ?

A flora donor candidate is first required to meet the requirements of Table 1 above. The donor candidate who meets the requirements set out in Table 1 is then examined and subjected to a set of basic biochemical tests. The donor is then scored based on the criteria in Table 2 below to get an idea of the quality of the donor’s flora.

Please contact us for detailed information and pricing about endoscopic treatments for obesity and flora transplantation. Fecal Transplant, Leaky Gut Syndrome Treatment, Assoc. Prof. Dr. Murat Kanlıöz

Table 1: Exclusion Criteria for Donor Selection in Total Gastrointestinal Flora Transplantation

(*Source: Kanlioz M, Ekici U, Ferhatoğlu MF. Total Gastrointestinal Flora Transplantation in the Treatment of Leaky Gut Syndrome and Flora Loss. Cureus. 2022 Nov 3;14(11):e31071. DOI: 10.7759/cureus.)

Table 2: Scoring of Donor Quality

 

(*Source: Kanlioz M, Ekici U, Ferhatoğlu MF. Total Gastrointestinal Flora Transplantation in the Treatment of Leaky Gut Syndrome and Flora Loss. Cureus. 2022 Nov 3;14(11):e31071. DOI: 10.7759/cureus.)