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Management of allergy transfer upon solid organ transplantation

Vionnet, Julien
Beyeler, Franziska
Scherer, Kathrin
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CollaborationWith : Gasche-Soccal, Paola Marina Alessandra / Posfay Barbe, Klara / Lovis, Christian
Published in American journal of transplantation. 2019, vol. 20, no. 3, p. 834-843
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, three cases (0.5%) of fatal anaphylaxis were identified, two because of peanut and one of wasp allergy. The sera of all three donors and their ten paired recipients, prospectively collected before and after transplantation from the Swiss-Transplant-Cohort-Study, were retrospectively processed using a commercial protein microarray fluorescent test. As early as five days post-transplantation, newly acquired peanut-specific IgE were transiently detected from one donor to three recipients, of whom one 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 five 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.
Keywords Solid organ transplantationAllergy transferImmunosuppressionManagementAnaphylaxisImmunoglobulin EIgE
PMID: 31535461
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Research groups Groupe Gasche-Soccal Paola (958)
La transplantation d'îlots de Langerhans (623)
Pathogenèse et traitement des allergies alimentaires (191)
Recherche en infectiologie pédiatrique et en pédiatrie générale (853)
Transplantation et hépatologie (905)
Swiss National Science Foundation: P300PB_174500
Swiss National Science Foundation: FUP096, CGR73771
(ISO format)
MULLER, Yannick et al. Management of allergy transfer upon solid organ transplantation. In: American Journal of Transplantation, 2019, vol. 20, n° 3, p. 834-843. doi: 10.1111/ajt.15601 https://archive-ouverte.unige.ch/unige:132970

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Deposited on : 2020-03-24

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