Management of allergy transfer upon solid organ transplantation.

Abstract

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.

• Authors: Yannick D Muller, Julien Vionnet, Franziska Beyeler, Philippe Eigenmann, Jean-Christoph Caubet, Jean Villard, Thierry Berney, Kathrin Scherer, Francois Spertini, Michael P Fricker, Claudia Lang, Peter Schmid-Grendelmeier, Christian Benden, Pascale Roux Lombard, Vincent Aubert, Franz Immer, Manuel Pascual, Thomas Harr, Swiss Transplant Cohort Study
• Journal: American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons (Am J Transplant) Vol. 20 Issue 3 Pg. 834-843 (03 2020) ISSN: 1600-6143 [Electronic] United States
• PMID: 31535461 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Review)
• Copyright: © 2019 The Authors. American Journal of Transplantation published by Wiley Periodicals, Inc. on behalf of The American Society of Transplantation and the American Society of Transplant Surgeons.

Chemical References

• Immunoglobulin E

Topics

• Cohort Studies
• Humans
• Immunoglobulin E
• Organ Transplantation (adverse effects)
• Peanut Hypersensitivity
• Retrospective Studies