Increase in de novo allergies after paediatric liver transplantation: the Brisbane experience

Area of Science:

• Pediatric Gastroenterology
• Transplant Immunology
• Allergy and Immunology

Background:

• Pediatric liver transplantation (OLT) offers a 10-year survival rate of 70%, with a focus on post-transplant quality of life.
• Allergic disorders are increasingly prevalent, with a noted rise in food allergies post-solid organ transplantation, particularly in children.
• The impact of de novo allergies on morbidity following pediatric OLT has not been well-defined.

Purpose of the Study:

• To determine the incidence of de novo allergies that develop after pediatric liver transplantation.
• To assess the contribution of these allergies to morbidity in pediatric OLT recipients.

Main Methods:

• A comprehensive review of medical records was conducted for pediatric liver transplant recipients over an 11-year period.
• Data collected included patient demographics, transplant details, and documented allergic conditions post-transplantation.

Main Results:

• Of 60 pediatric OLT survivors, 24 (40%) developed documented allergic disease.
• De novo food allergies were diagnosed in 12 (20%) survivors, with 9 of these occurring in infants at the time of transplant.
• Severe allergies, including anaphylaxis, were noted in 10 of the 12 children with food allergies, highlighting a significant risk.

Conclusions:

• Clinically significant allergic disease, especially de novo food allergies in infants post-OLT, is a critical concern.
• These findings underscore the need for targeted specialist allergist referral and proactive risk management strategies for at-risk pediatric OLT patients.