This is a question I have been asked a few times before. How did I get my donor screened? I ended up NOT having any testing done, simply because I realized from my donor’s medical history and the incidence of such cases within the U.S. (epidemiology) that there was basically no chance that they had any of the diseases, bacteria or parasites that they would test for. Some might say this is crazy, however these are my reasons.
1) I could NOT simply go to a lab and request testing to be done, even if I were willing to pay out of pocket. I called a few labs and was told that I could not just request testing, I would have to have a doctor request this. Even if they had covered it, it becomes more complicated when you consider the out of pocket costs for such tests.
2) You can know with a high degree of confidence whether or not your donor has the illnesses you are testing for by getting a good idea of their medical history, this includes blood born pathogens and bacteria often found in Traveler’s Diarrhea. Most of the blood born pathogens are relatively uncommon in the population as a whole and are most commonly found in people with certain risk factors relating to sexual behavior.
The testing recommended in “Success of Self-Administered Home Fecal Transplantation for Chronic Clostridium difficile Infection” (Silverman et al) recommends the following tests. However are they all necessary? I decided that they were not for me.
Blood Tests included
human immunodeficiency virus (HIV), syphilis enzyme immunoassay, Hepatitis A, B and C, Helicobacter pylori antibody (a bacteria that causes stomach ulcers)
Stool test included:
from both donors and recipients were obtained for culture and sensitivity, ova, and parasites, cryptosporidia, microspora and Clostridium difficile (c diff) toxin.
First off, why test the recipient? We already know that their guy is not doing well? Honestly it appears to mostly be academic especially if you have been tested at some point in the past. In the case of c. diff related Colitis it might be worth knowing whether or not the person really does have c. diff bacteria or not. Other parasites might be contributing factors, but can anything be done about them? The fecal transplant is the most effective option at eliminating c diff bacterial infection. It might also help either eliminated or dramatically reduce the effects of other bacteria and parasites by establishing a sufficiently strong colony to suppress the other bacteria.
In my case I have already had stool testing before and it had come back negative. So there were no detectible parasites or bacteria that they have tests for.
Testing the donor. Once again do they have any symptoms of STDs like Syphillis, AIDS or Hepatitis? Have they engaged in behavior that makes it at all likely they would have contracted various STDs? Do they have any symptoms or have ever had any symptoms of bacterial infection or parasites in the intestines? Have they been to countries where certain bacteria and parasites are known to be a problem?
Bottom line, know your donor well and certainly evaluated their medical history. Given accurate information from the donor’s medical history that you can trust, testing may not really be necessary in many cases.