Development and decline of peanut allergy following a lung transplant

The following is the report from a case study published in the Canadian Respiratory Journal.

A 47 year old woman received a pair of lungs from a twelve year-old with a known peanut allergy. After the transplant the patient experienced four anaphylactic reactions. A skin prick test (SPT) was initially positive and declined steadily during the course of a year when it reverted to negative. The patient then underwent an oral challenge which returned negative results. 

Transfer of food allergy after an organ transplant is theorised to occur via the transfer of donor B lymphocytes which produce peanut-specific immunoglobulin E (IgE) into the blood circulation of the recipient patient. Another theory suggests that it may be the passive transfer of IgE-sensitised mast cells and/or basophils within the transplanted tissue that move into the recipient's tissues. The decline in the magnitude of sensitivity to peanut over the year following transplant indicates the gradual depletion of sensitised cells, and supports the theory of initial passive transfer of sensitised cells from the donor to the recipient during transplantation. However, this occurrence needs to be considered when donor organs are taken from allergic individuals.

Source: Canadian Respiratory Journal

First Published in June 2011

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