Sweden’s Region Skåne faces a significant shortage of fecal donors as it expands a vital treatment for patients with severe, recurrent intestinal infections. The demand for donors is increasing to shorten waitlists for those suffering from debilitating diarrhea following antibiotic treatments. At Skåne University Hospital in Lund, capsules containing healthy gut bacteria have been manufactured for a year. The region now aims to offer this treatment at all infection clinics in Skåne by the end of this year, a goal entirely dependent on recruiting more donors.
A Treatment Built on Healthy Microbiomes
The treatment, known as fecal microbiota transplantation (FMT), involves transferring processed stool from a healthy, screened donor to a patient. It is primarily used for patients with recurrent Clostridioides difficile infection (CDI), a condition that causes severe, life-altering diarrhea and often emerges after antibiotic use disrupts the natural gut flora. The healthy bacteria from a donor can recolonize the patient's gut and defeat the infection where antibiotics have failed. "Every patient waiting for treatment is dependent on bacteria that only a healthy donor can provide," said Sara Hansson, a nurse within the infection care unit, in a press statement. "We already see that the need will increase during 2026."
The Rigorous Path to Becoming a Donor
Becoming a stool donor is not a simple process. Potential donors undergo a screening process as stringent as that for blood donors, but focused on gastrointestinal health. Candidates must be in excellent general health, with a stable body weight and a regular, well-formed stool pattern. They cannot have any history of chronic gastrointestinal diseases, metabolic syndrome, or recent antibiotic use. They are also screened for a wide array of transmissible pathogens, including HIV, hepatitis, and various parasites and bacteria. This intensive vetting is necessary to ensure the safety of the transplanted material for immunocompromised recipients. The commitment involves regular donations over a period, as consistency in the donor's microbiome is valuable for producing standardized treatments.
The Science Behind the Expansion
The push to expand access across Skåne is backed by growing clinical evidence. Studies show FMT has a success rate exceeding 90% for recurrent CDI, far outperforming repeated courses of antibiotics. The treatment at Lund hospital uses encapsulated, frozen microbiota, which is easier to store, administer, and standardize compared to older methods like colonoscopy delivery. This technological advance makes wider distribution feasible. The regional health authority's decision to scale up the program reflects its transition from a research-based therapy to a standard clinical offering within the Swedish public healthcare system. The bottleneck is no longer medical acceptance but the supply of the fundamental ingredient: rigorously screened, healthy donor material.
A Broader Look at Gut Health
This shortage in Skåne highlights a larger, global interest in the human microbiome's role in health. While FMT for CDI is well-established, research is exploring its potential for other conditions like ulcerative colitis, irritable bowel syndrome, and even some neurological disorders. Sweden, with its centralized healthcare registries and research institutions like the one in Lund, is a notable contributor to this field. The current donor drive is squarely focused on the immediate, life-changing application for CDI patients. However, a stable donor pool is also a strategic resource for future clinical research that could benefit from prepared, standardized microbiota products.
The Human Cost of the Shortage
Behind the clinical language and microbiological science are patients whose lives are on hold. Recurrent CDI often means numerous hospital visits, an inability to work, social isolation due to urgency and incontinence, and a severely reduced quality of life. For them, the donor shortage translates directly into prolonged suffering and increased risk of complications. The regional healthcare system also bears a cost, as treating these patients with conventional, less effective methods is more resource-intensive over time. Successfully recruiting donors is therefore both a humanitarian and an economic imperative for the publicly funded health service.
How the Donation Process Works
For those who qualify, the donation process is designed to be discreet and straightforward. Donors typically visit a clinic where they provide a sample in a private room using a special collection kit. The sample is then immediately processed in a dedicated laboratory. It is homogenized, filtered, and prepared for either encapsulation or freezing. Donors are often compensated for their time, similar to blood plasma donation, acknowledging the value of their contribution and the commitment required. Region Skåne's campaign aims to demystify the process and encourage healthy individuals to see donation as a legitimate and impactful act of giving, comparable to donating blood or organs.