Sterile faecal filtrate production and administration
STERILE, -20
Production of the sterile faecal filtrate started the day before administration to the MetSyn subjects. First, 50 g of stool was collected from a screened donor, which was homogenised with 500 ml sterile saline. Large particles were filtered from the faecal suspension using double sterile gauzes. Most of the bacteria were removed in two subsequent centrifugation steps, in which the suspension was spun for 1 h at 10.000×The sterile faecal filtrate was administered to the patient via a nasoduodenal tube. The day prior to the administration, subjects were asked to clean their bowel using a laxative (Klean-Prep®, Norgine B.V.), which is a standard pre-treatment for FMT procedures in our hospital. Nasoduodenal tubes were placed with the help of a Cortrak®2 enteral access system (Avanos Medical Inc.), making sure the nasoduodenal tube was correctly positioned. The faecal filtrate was slowly infused with a 60 ml syringe, on average 300 ml during a 15-20 min period. Supplementary Fig. During the optimisation of the tangential flow filtration, we quantified the VLP numbers of the faecal filtrates from four different donors, as previously described