Date: Tuesday, June 5, 2018
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall 4EF
Introduction: Transplant Acquired Food Allergy may cause fatal allergic reactions, and is an under-recognized and poorly understood. Specifically, nut allergy transfer after solid organ transplantation has occasionally been described in recipients.
Methods: The multidisciplinary OPTN DTAC evaluates potential donor derived transmission events in the United States. Six cases (four bilateral lung, two liver recipients) of potential donor-derived nut allergy were reported to DTAC between 2011-2016.
Results: There were 27 recipients from 6 donors. Donor age was 11-20 years (median 14.5), 5 were males. All donors but none of the recipients had known nut allergies. There were 9 DTAC adjudicated proven disease transmissions: 4 cases of anaphylaxis, one of which resulted in death, 4 non-anaphylactic reactions, and 1 recipient who tested positive without clinical illness. Symptomatic nut allergy occurred in 4/4 (100%) lung transplants, 4/6 (67%) liver transplants, 1/13 (8%) kidney recipients (kidney-pancreas) and none of the 3 evaluable heart recipients. The allergic reaction presented 7 days to 56 days after transplantation.
Conclusions: De novo nut allergy following solid organ transplantation is fortunately extremely rare. Most cases presented to DTAC occurred unexpectedly and were life threatening. While numbers are small it appears that organs with increased amounts of transplanted donor lymphoid tissue such as lung and liver are at highest risk. As food allergies can be successfully managed by avoidance of the food antigen, history of food allergies should to be included in the uniform donor history questionnaires. Transplant teams should be vigilant and take preventive steps to avoid potentially life-threatening events following transplantation of organs from a donor with known food allergies.
CITATION INFORMATION: Bag R., Tlusty S., Vece G., Peterson T., Schaenman J., Berry G., Bucio J., Danziger-Isakov L., Florescu D., Goldberg D., Ho C., La Hoz R., Lilly K., Malinis M., Mehta A., Nalesnik M., Sawyer R., Strasfeld L., Wood P., Theodoropoulos N., Michaels M., Wolfe C. Donor Transmitted Nut Allergy Following Solid Organ Transplantation: Analysis of the OPTN Ad Hoc Disease Transmission Advisory Committee (DTAC) Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:Bag R, Tlusty S, Vece G, Peterson T, Schaenman J, Berry G, Bucio J, Danziger-Isakov L, Florescu D, Goldberg D, Ho C, Hoz RLa, Lilly K, Malinis M, Mehta A, Nalesnik M, Sawyer R, Strasfeld L, Wood P, Theodoropoulos N, Michaels M, Wolfe C. Donor Transmitted Nut Allergy Following Solid Organ Transplantation: Analysis of the OPTN Ad Hoc Disease Transmission Advisory Committee (DTAC) [abstract]. https://atcmeetingabstracts.com/abstract/donor-transmitted-nut-allergy-following-solid-organ-transplantation-analysis-of-the-optn-ad-hoc-disease-transmission-advisory-committee-dtac/. Accessed July 4, 2020.
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