Access for children is especially challenging. Most banks collect samples only from adults, and transplanting them into children may cause unwanted side effects. Nikhil Pai, a pediatric gastroenterologist at McMaster Children’s Hospital and associate professor at McMaster University, is helping to change things. In 2022, he set up the first pediatric stool bank in Canada. Since then, the bank has stored more than 150 samples and completed five FMT procedures in children. Pai is collaborating with other researchers on designing oral “crapsules” to make treatment easier. 

Managing a stool bank: Pai and his colleagues take on multiple roles to keep the bank running. They recruit and screen donors, catalogue the samples, store them in a freezer at −80 °C,and fundraise to keep the effort going. The bank also provides stool to researchers testing FMT as a treatment for other diseases. “There’s a lot of different roles that we’ve taken on to be able to do this,” Pai says.

From donation to treatment: The bank recruits donors throughout the hospital. The healthy siblings of patients or children of hospital staff are eager to help. “There is a very strong sense of citizenship that leads children to want to volunteer,” he says.