A 47-year-old woman underwent bilateral lung transplantation for nonspecific interstitial pneumonitis and received donor lungs from a 12-year-old patient with a known peanut allergy. Post-transplant, the patient experienced four anaphylaxis-like reactions. A skin prick test to peanut was initially positive; however, it steadily declined over serial assessments and reverted to negative one year post-transplant. The patient subsequently had a negative oral peanut challenge. Transfer of food allergy post-transplantation is theorized to occur via transfer of donor B lymphocytes producing peanut-specific immunoglobulin E into the circulation of the recipient. An alternate mechanism proposes passive transfer of immunoglobulin E-sensitized mast cells and⁄or basophils within the transplanted tissue that subsequently migrate into recipient tissues. The gradual decline in the magnitude of the peanut skin prick test and its return to negative over the course of one year supports the gradual depletion of sensitized cells in the recipient (B lymphocytes and, possibly, mast cells), and supports the initial passive transfer of sensitized cells from donor tissue during transplantation. This should be considered when donor organs are obtained from allergic individuals.
The Environmental Exposure Unit (EEU) is a 924 m 3 facility (Kingston General Hospital, Ontario) in which uniform concentrations of various pollens in HEPA-filtered air at known rates of laminar airflow can be maintained. This facility provided a unique opportunity to compare several air samplers without the environmental variation inherent in outdoor comparisons. The purpose of this study was to conduct a quantitative comparison of pollen measurements using the Rotorod, Burkardä Personal Volumetric Air Sampler, Air-O-Cellä and a 37 mm open-faced filter cassette with a microporous filter in the EEU. Pollen samples were taken during clinical trials being conducted in the Unit. Raw pollen counts/m 3 obtained using the different methods were corrected using published particle collection efficiencies for the particle size ($20 lm) and airflow. Data were analyzed by ANOVA/Tukey HSD. No statistically significant differences were found between pollen concentrations determined by Rotorod, Air-O-Cell and filter cassette. Pollen levels determined by the Burkard were up to 2 times higher than the other sampling methods. Relative standard deviations were similar for the Rotorod, Burkard, and filter cassette and higher for the Air-O-Cell. This study demonstrated that, under our conditions, the Rotorod sampler provides consistent and reliable measurements of ragweed pollen concentrations.
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