You might have heard of donating blood on your lunch break, but what about popping out to donate faeces?
That is what Red Cross Lifeblood is encouraging people to do in Perth.
Its WA facility takes donated stool and processes it into the medical product used for lifesaving faecal microbiota transplants (FMT) which is then sent around the country.
Hospitals throughout Australia use FMT to treat a debilitating and deadly gut infection, Clostridioides difficile or C. diff, which affects 6,000 Australians each year.
FMT involves taking the faeces of a healthy person and processing into a medical product full of good gut bacteria.
When that healthy microbiota is transplanted into the gut of a person with C. diff, the healthy bacteria overwhelm the infection.
'There was talk of removing my bowel'
A few years back, Esperance man Kevin Young could not catch a break.
After fire destroyed his house, Mr Young was diagnosed with bowel cancer and complications from surgery led to him becoming incredibly unwell with C. diff.
"In its mildest form it is extreme diarrhoea. At its most severe, C. diff produces a very nasty toxin that in its highest concentrations can shut down your vital organs," he said.
"Mine was getting pretty bad, and there was talk of removing my bowel to just get rid of the infection."
Living life to the full
Antibiotics failed to rid him of the debilitating infection, so Mr Young was given FMT.
He felt better within days and the semi-retired agricultural scientist and talented wheat breeder is now getting the most out of life.
"I've got a few beehives, an olive grove established, I'm working on my vineyard," Mr Young said.
"So, I'm going to be doing semi-retirement for as long as I can, which will include the work that I love, and growing treats out at my bush block.
"I've been accused of hobby overload, but that's how I like it."
High cure rate in trial
A clinical trial at Fiona Stanley Hospital in Perth has shown FMT to be a safe and effective treatment for C. diff infection, with a 70 to 90 per cent cure rate.
According to WA Health, it is reducing the need for antibiotics and saving $14,000 to $24,000 per patient in hospital costs.
Gastroenterologist Dr Oliver Waters worked on one of Western Australia's earliest stool transplants at Fremantle Hospital in 2013 to treat a man with C. diff.
"Clostridioides difficile is an infection of the gut, it gives you profuse, watery diarrhoea, and you can be very unwell, have fevers, and just feel genuinely terrible," Dr Waters said.
"It kills a lot of people, and it takes a long time to do that.
"This guy became more and more unwell … and he'd had so many courses of antibiotics and none of them had worked."
After more than 100 days in hospital, the patient was running out of options and Dr Waters decided it was time to try a stool transplant.
'I'm well, I'm cured'
"The patient's sister donated it, and we had to blend the stool in the room, which was really quite a challenging and disgusting experience," he said.
"We gave it to him at 11:00am and I went back to see him at 3:00pm and he was sitting up in bed and he said, 'I'm well, I'm cured'."
Dr Waters said a decade on it was still incredible to see patients get better in front of his eyes after undergoing FMT and that the process itself had gotten a lot easier.
"We've now treated over 80 people with it, and the cure rate is over 95 per cent, so it's really quite impressive," he said.
"And now, I just simply send off an email and it arrives in a nice sterile box, I defrost it, and then I put it into the patient with a colonoscopy, it's infinitely better."
Perth poo shipped nationwide
To create the FMT product, a donation is collected on site at Red Cross Lifeblood in Perth.
It is immediately tested before being processed, then frozen below -70 degrees Celsius.
Much of the precious frozen cargo that leaves the facility is flown interstate.
Lifeblood's Elizabeth Connolly, said Perth locals and city workers were needed as donors.
"People can do it first thing in the morning before they head to work, or during their lunch break," she said.
A suitable donor is someone aged between 18 and 50, who feels healthy.
'Easier than blood donation'
Perth woman, Laurynne Joyce, was already a regular blood donor before she became a microbiota donor.
"It's even easier than blood donation," she said.
"For me it's quite simple, I come in the mornings, donate, and head off to work."
Production periods run for two weeks at a time and Lifeblood asks its donors to visit as many times as possible during that fortnight.
Donors sign in, have a quick interview with a healthcare professional, and can make use of a donor refreshment room to enjoy coffee and snacks before or afterwards.
"If these donations are going to be flushed away, then why not put them to good use?" Ms Connolly said.
Ms Connolly thanked the WA government for its $2.5 million contributed to the program.
"This funding will enable us to expand our microbiome program, and we're looking to different delivery methods for FMT, such as enema, or capsule," she said.
"We'll also be starting another clinical trial in conjunction with Fiona Stanley Hospital where FMT will be used to reduce the acquisition of multi-resistant organisms in the ICU setting."
ICU doctor Tess Evanshas been studying the microbiome of critically ill patients.
"What we know about critical illness is that the gut microbiome is essentially demolished," Dr Evans said.
"The idea of Faecal Microbiota Transfer is to replenish the gut, to repopulate the gut flora, and by that token, try to hasten recovery from critical illness.
"In WA, we should be proud of our microbiome bank, and I really encourage people to contribute, because we do need that data, and we do need those poos."
Editor's note: A previous version of this story said Lifeblood's Perth facility was the only place in the country which makes FMT. This was incorrect.
