title: Passive transfer of nut allergy after liver transplantation.
abstract: An anaphylactic reaction to cashew nut developed in a nonatopic 60-year-old man 25 days after receiving a liver allograft from a 15-year-old atopic boy who died of anaphylaxis after peanut ingestion. The liver recipient had no history of nut allergy. Posttransplantation skin prick test results were positive for peanut, cashew nut, and sesame seed, and the donor had allergen-specific IgE antibodies to the same 3 allergens. Contact tracing of the recipients of other solid organs from the same donor disclosed no other development of allergic symptoms after ingestion of peanut or cashew nut. Results of molecular HLA typing did not detect any donor-origin leukocytes in the recipient after transplantation, which excluded peripheral microchimerism. The patient inadvertently ingested peanut-contaminated food and suffered a second anaphylactic reaction 32 weeks after the transplantation. This case illustrates that transfer of IgE-mediated hypersensitivity can occur after liver transplantation and have potentially serious consequences. We therefore recommend that organ donors undergo screening for allergies, and that recipients be advised regarding allergen avoidance.
authors.affiliation: Department of Clinical Immunology, Royal Prince Alfred Hospital, Missenden Road, Camperdown, Sydney 2050, New South Wales, Australia. tri.phan@email.cs.nsw.gov.au
authors.forename: Tri Giang
authors.initials: TG
authors.lastname: Phan
authors.forename: Simone I
authors.initials: SI
authors.lastname: Strasser
authors.forename: David
authors.initials: D
authors.lastname: Koorey
authors.forename: Geoff W
authors.initials: GW
authors.lastname: McCaughan
authors.forename: Janet
authors.initials: J
authors.lastname: Rimmer
authors.forename: Heather
authors.initials: H
authors.lastname: Dunckley
authors.forename: Louise
authors.initials: L
authors.lastname: Goddard
authors.forename: Stephen
authors.initials: S
authors.lastname: Adelstein
mesh_terms: D000707:Anaphylaxis / Q000276:immunology*; D006801:Humans; D007108:Immune Tolerance; D016031:Liver Transplantation / Q000009:adverse effects / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D021184:Nut Hypersensitivity / Q000276:immunology*; D021183:Peanut Hypersensitivity / Q000276:immunology*