Publication Name	World Journal of Hepatology
Manuscript ID	116153
Country	India

Category	Medicine, General & Internal
Manuscript Type	Randomized Controlled Trial
Article Title	Impact of two-session fecal microbiota transplantation on minimal hepatic encephalopathy in cirrhosis
Manuscript Source	Invited Manuscript
All Author List	Ankit Agarwal, Samagra Agrawal, Daizee Talukdar, Manjeet Kaur, Sagnik Biswas, Shekhar Swaroop, Rithvik Golla, Bharti Kandiyal, Pradip Jana, Subhash Tanwar, Arnav Aggarwal, Hem C Singh, Ayush Agarwal, Mridul Mahajan, Bipin Tiwari, Baibaswata Nayak, Amit Goel, Bhabatosh Das and Shalimar
Funding Agency and Grant Number	Funding Agency Grant Number Department of Biotechnology (DBT), Govt. of India No. BT/PR30159/MED/15/188/2018 Science and Engineering Research Board No. SPR/2020/00315 Blockchain For Impact No. 2025
Corresponding Author	Shalimar, Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, Delhi, India. drshalimar@gmail.com
Key Words	Minimal hepatic encephalopathy; Fecal microbiota transplantation; Probiotics; Lactulose; Bacteria
Core Tip	Minimal hepatic encephalopathy (MHE) is common in cirrhosis. Gut dysbiosis is a key pathogenic player of MHE. Lactulose has been demonstrated to reverse MHE and prevent progression to overt HE. This randomised trial compared two endoscopic fecal microbiota transplantations (1 month apart) with daily lactulose over 3 months for MHE reversal. We found fecal microbiota transplantation and lactulose to have similar efficacy in improving MHE, supporting microbiota-targeted therapy as a viable alternative to standard care for MHE. These findings justify larger trials to assess long-term outcomes and optimal microbiota-based strategies.
Citation	Agarwal A, Agrawal S, Talukdar D, Kaur M, Biswas S, Swaroop S, Golla R, Kandiyal B, Jana P, Tanwar S, Aggarwal A, Singh HC, Agarwal A, Mahajan M, Tiwari B, Nayak B, Goel A, Das B, Shalimar. Impact of two-session fecal microbiota transplantation on minimal hepatic encephalopathy in cirrhosis. World J Hepatol 2026; In press

Received	2025-11-04 04:45
Peer-Review Started	2025-11-04 04:45
First Decision by Editorial Office Director	2025-11-26 09:32
Return for Revision	2025-11-26 09:46
Revised	2025-12-08 06:57
Publication Fee Transferred
Second Decision by Editor	2026-02-06 02:44
Second Decision by Editor-in-Chief
Final Decision by Editorial Office Director	2026-02-06 07:12
Articles in Press	2026-02-06 07:12
Edit the Manuscript by Language Editor
Typeset the Manuscript

ISSN	1948-5182 (online)
Open Access	This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Copyright	© The Author(s) 2026. Published by Baishideng Publishing Group Inc. All rights reserved.
Permissions	For details, please visit: http://www.wjgnet.com/bpg/gerinfo/207
Publisher	Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
Website	http://www.wjgnet.com