期刊
AMERICAN JOURNAL OF TRANSPLANTATION
卷 20, 期 3, 页码 834-843出版社
WILEY
DOI: 10.1111/ajt.15601
关键词
allergy; allergy transfer; anaphylaxis; business; management; clinical decision-making; clinical research; practice; diagnostic techniques and imaging; guidelines; IgE; immunoglobulin E; immunosuppression; immunosuppression; immune modulation; management; organ transplantation in general; patient safety; solid organ transplantation
资金
- Swiss National Research Fund [P300PB_174500]
- Swiss Transplant Cohort Study [FUP096, CGR73771]
- Ulrich Muller Gierok Foundation [CGR 73774]
- Swiss National Science Foundation (SNF) [P300PB_174500] Funding Source: Swiss National Science Foundation (SNF)
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.
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