Intestinal Microbiota Transplant in Alcohol-Associated Liver Disease

This study tests whether intestinal microbiota transplantation (IMT) — transferring healthy gut bacteria from a donor into a patient — can help people with severe alcohol-related liver disease (ALD) who continue to drink and have not been able to stop with conventional addiction treatments. The gut microbiome plays a major role in liver health, and IMT may help by rebalancing gut bacteria, reducing liver inflammation, and potentially reducing cravings for alcohol. You may be eligible if: - You are over 18 years old - You have advanced liver disease caused by alcohol - You continue to drink alcohol - You have previously declined or failed traditional alcohol use disorder treatment - You are able to give informed consent You may NOT be eligible if: - You have recent or current alcoholic hepatitis or alcohol withdrawal symptoms - Your liver disease is very severe (MELD score above 17) - You have uncontrolled mood disorders or primary psychotic conditions - You have current hepatic encephalopathy being treated with lactulose or rifaximin - You are pregnant or breastfeeding - You have serious conditions like chronic inflammatory gut disease (Crohn's, ulcerative colitis), dysphagia, history of bowel obstruction, or a known gut cancer - You have an allergy to capsule ingredients or a history of severe anaphylactic food allergy Talk to your doctor to see if this trial is right for you.