title: Post-transplant food allergy in children is associated with liver and not with renal transplantation: a monocentric comparative study.
abstract: Food allergy is increasingly reported after paediatric liver transplantation. The underlying physiopathological mechanism remains incompletely understood. Therefore, we aimed to determine the incidence, clinical presentation, possible risk factors, and prognosis of post-transplant food allergy in children currently followed after liver and renal transplantation. The study population consists of 49 liver and 21 renal transplant patients transplanted between the age of 22 months and 15 years. Data were collected retrospectively from medical records and via a doctor's questionnaire taken from the parents in a monocentric setting. Post-transplant food allergy has developed in 13 liver transplant patients and in none of the renal transplant recipients. Within the liver transplant group, median age at liver transplantation is significantly lower in the food-allergic (10 months) versus non-food-allergic group (3.3 years; p = 0.002). The use of tacrolimus as primary maintenance immunosuppression is associated with food allergy (p = 0.032) and mean donor age is significantly lower in the food-allergic group (p = 0.009). Compared to the renal transplant group, median age at transplantation is significantly lower in the liver patients (p < 0.001). No significant differences are found in primary immunosuppressive regimens between renal and liver transplant patients.
  
  
  CONCLUSIONS
  Post-transplant food allergy is an important clinical problem in children after liver transplantation which does not affect renal transplant patients despite similar immunosuppressive regimens. Within the group of liver transplant recipients, tacrolimus use, young age at time of transplant and younger donor age were associated with the development of food allergy.
authors.affiliation: Department of Paediatric Gastroenterology, Hepatology and Nutrition, Princess Elisabeth Children's Hospital, Ghent University Hospital, Belgium De Pintelaan 185, 9000 Ghent, Belgium. ruth.debruyne@ugent.be
authors.forename: Ruth
authors.initials: R
authors.lastname: De Bruyne
authors.forename: Melissa
authors.initials: M
authors.lastname: Dullaers
authors.forename: Stephanie
authors.initials: S
authors.lastname: Van Biervliet
authors.forename: Saskia
authors.initials: S
authors.lastname: Vande Velde
authors.forename: Ann
authors.initials: A
authors.lastname: Raes
authors.forename: Philippe
authors.initials: P
authors.lastname: Gevaert
authors.forename: Myriam
authors.initials: M
authors.lastname: Van Winckel
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D005260:Female; D005512:Food Hypersensitivity / Q000453:epidemiology / Q000209:etiology* / Q000276:immunology; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D016030:Kidney Transplantation / Q000009:adverse effects*; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D012044:Regression Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D016559:Tacrolimus / Q000009:adverse effects* / Q000276:immunology
chemical_list: D007166:Immunosuppressive Agents; D016559:Tacrolimus