Transfer of Peanut Allergy From the Donor to a Lung Transplant Recipient

Khalid, Imran; Zoratti, Edward M.; Stagner, Lisa; Betensley, Alan D.; Nemeh, Hassan; Allenspach, Lisa

doi:10.1016/j.healun.2008.07.015

Cited by 26 publications

(15 citation statements)

References 22 publications

(26 reference statements)

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“…Five cases of food allergy have been reported in adults receiving liver transplantation with all cases involving development of peanut and/or tree nut [walnut (35) and cashew (37)] allergies. Two cases of peanut allergy were reported after lung transplantation (39, 40). Interestingly, in two of the cases where a heart transplant was performed from the same peanut allergic donor of a liver transplant to a separate individual, the recipient of the liver developed peanut allergy while the heart transplant recipient did not develop allergic disease (38, 39).…”

Section: Discussionmentioning

confidence: 99%

Presentation of atopic disease in a large cohort of pediatric liver transplant recipients

Shroff

Mehta

Chinen

et al. 2012

Pediatric Transplantation

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Atopic disease occurs in solid organ transplant recipients with an increasingly recognized frequency. The time course for the development of these atopic diseases in liver transplantation has not been described. The objective was to characterize the atopic manifestations of children receiving chronic immunosuppression after orthotopic liver transplantation (OLT). Chart review and follow-up questionnaire were utilized for 176 OLT pediatric recipients at a single institution for manifestations of allergic disease. Atopic disease was present in 25 (14.2%) patients. Median age at transplant was 16 months with a median follow-up of 63 months. Food allergy and non-food related atopic symptoms presented at a median of 11.5 (IQR, 6-28) and 19 (IQR, 5-41) months post-transplantation, respectively. The median age at transplant of the non-atopic children was 72 months, higher than patients with atopy (p < 0.001). Food allergy and atopic skin disease symptoms were present in 40% and 56% of cases, respectively. Asthma, allergic rhinitis, or both were found in 66% of cases. The onset of symptoms of food allergy and eczema (median, 12 months post-transplantation) preceded symptoms of allergic rhinitis and asthma. (median of 27 and 30 months post-transplantation, respectively). Atopy occurs in ∼14% of pediatric liver transplant recipients, with manifestations including food allergy, eczema, allergic rhinitis, and asthma.

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Section: Discussionmentioning

confidence: 99%

Presentation of atopic disease in a large cohort of pediatric liver transplant recipients

Shroff

Mehta

Chinen

et al. 2012

Pediatric Transplantation

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“…The only reported case of the transfer of food allergy following lung transplantation to date was described by Khalid et al [36] in 2008. A 42-year-old woman with a history of sarcoidosis successfully received a bilateral lung transplant from a 12-year-old donor with asthma and peanut allergy who died from an allergic reaction following the ingestion of a peanut-containing food.…”

Section: Association With Other Organ Transplantsmentioning

confidence: 99%

“…The possibility of persistent production of IgE confined to the transplanted organ is suggested by the case involving the recipient of a lung transplant from a peanut allergic donor [36] and the case of the adult who reacted to walnut after receiving a liver transplant from a nut allergic donor [24]. The reactions occurring in these patients in the absence of positive skin tests or the ability to identify serum food allergen-specific IgE near the time of the reaction reinforce the need for caution in the evaluation of these patients.…”

Section: Proposed Mechanismsmentioning

confidence: 99%

Food Allergy: Transfused and Transplanted

Atkins

Malka-Rais

2010

Curr Allergy Asthma Rep

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The inadvertent transfer of food allergy from an allergic donor to an unsuspecting recipient by transfusion or organ donation is a relatively rare but intriguing event with potentially catastrophic consequences. Additionally, the development of food allergy in the recipient of a transplant from a donor who was not food allergic poses questions about why this occurs, why it is observed more frequently in some situations than others, and the mechanisms that may be involved. In this review, the transfer of food allergy by transfusion, bone marrow transplantation, and the transplantation of different solid organs is explored, and potential mechanisms in addition to the importance of careful monitoring are discussed.

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“…The first cases of transplant‐associated allergy transfer were reported after hematopoietic stem cell transplantation, likely caused by IgE‐specific B cells or T helper type 2 cells that were cotransferred with hematopoietic stem and progenitor cells . Subsequently, cases of allergy transfer were also described after solid organ transplantation (SOT), predominantly after liver, lung, or combined pancreas‐kidney transplantation (Table ) . Only very few data are available as to the frequency, significance and mechanisms of IgE transfer in the setting of SOT.…”

Section: Introductionmentioning

confidence: 99%

Management of allergy transfer upon solid organ transplantation

Müller

Vionnet

Beyeler³

et al. 2020

American Journal of Transplantation

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Allergy transfer upon solid organ transplantation has been reported in the literature, although only few data are available as to the frequency, significance, and management of these cases. Based on a review of 577 consecutive deceased donors from the Swisstransplant Donor‐Registry, 3 cases (0.5%) of fatal anaphylaxis were identified, 2 because of peanut and 1 of wasp allergy. The sera of all 3 donors and their 10 paired recipients, prospectively collected before and after transplantation for the Swiss Transplant Cohort Study, were retrospectively processed using a commercial protein microarray fluorescent test. As early as 5 days posttransplantation, newly acquired peanut‐specific IgE were transiently detected from 1 donor to 3 recipients, of whom 1 liver and lung recipients developed grade III anaphylaxis. Yet, to define how allergy testing should be performed in transplant recipients and to better understand the impact of immunosuppressive therapy on IgE sensitization, we prospectively studied 5 atopic living‐donor kidney recipients. All pollen‐specific IgE and >90% of skin prick tests remained positive 7 days and 3 months after transplantation, indicating that early diagnosis of donor‐derived IgE sensitization is possible. Importantly, we propose recommendations with respect to safety for recipients undergoing solid‐organ transplantation from donors with a history of fatal anaphylaxis.

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Transfer of Peanut Allergy From the Donor to a Lung Transplant Recipient

Cited by 26 publications

References 22 publications

Presentation of atopic disease in a large cohort of pediatric liver transplant recipients

Presentation of atopic disease in a large cohort of pediatric liver transplant recipients

Food Allergy: Transfused and Transplanted

Management of allergy transfer upon solid organ transplantation

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