Fecal Microbiota Transplantation for Liver Disease: Emerging Clinical Evidence and Gut-Liver Axis Mechanisms

DOI: 10.12201/bmr.202611.00004

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  Abstract: Fecal microbiota transplantation (FMT) is emerging as a therapeutic modality across a spectrum of liver diseases, including steatotic liver disease, alcoholic hepatitis, cirrhosis, hepatic encephalopathy, hepatocellular carcinoma, cholestatic disorders, and drug- and toxin-induced hepatotoxicity. Gut dysbiosis can appear early and worsen with disease, driving steatohepatitis, fibrosis, and hepatocarcinogenesis through barrier disruption, altered bile acid and short-chain fatty acid metabolism, and immune dysregulation. Despite these advances, the specific microbial consortia, underlying mechanisms, and optimal clinical regimens remain poorly defined. This review synthesizes recent preclinical and clinical evidence on FMT efficacy, safety, and durability, examines mechanisms from bile acid signaling to immune reprogramming, and integrates procedural and mechanistic insights to outline a path toward precision microbiome therapeutics in hepatology.

  Key words: Fecal microbiota transplantation (FMT); Gut microbiota; Gut-liver axis; Liver diseases; Hepatic encephalopathy; Microbiota-based therapy

  Submit time: 3 November 2026

  Copyright: The copyright holder for this preprint is the author/funder, who has granted biomedRxiv a license to display the preprint in perpetuity.
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  1	2026-09-10	10.12201/bmr.202611.00004V1	Download

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