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Management of allergy transfer upon solid organ transplantation
Author(s) -
Muller Yannick D.,
Vionnet Julien,
Beyeler Franziska,
Eigenmann Philippe,
Caubet JeanChristoph,
Villard Jean,
Berney Thierry,
Scherer Kathrin,
Spertini Francois,
Fricker Michael P.,
Lang Claudia,
SchmidGrendelmeier Peter,
Benden Christian,
Roux Lombard Pascale,
Aubert Vincent,
Immer Franz,
Pascual Manuel,
Harr Thomas
Publication year - 2020
Publication title -
american journal of transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.89
H-Index - 188
eISSN - 1600-6143
pISSN - 1600-6135
DOI - 10.1111/ajt.15601
Subject(s) - medicine , transplantation , allergy , anaphylaxis , immunoglobulin e , sensitization , immunology , peanut allergy , organ transplantation , desensitization (medicine) , kidney transplantation , food allergy , antibody , receptor
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.