Food Allergy in Liver Transplant Recipients

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F Mori et al. JPGN 2022; 74: 175-179. De Novo Food Allergy in Pediatric Recipients of Liver Transplant

This interesting review has several key points:

  • Reported prevalence of food allergy after liver transplant ranges from 5% to 40%
  • Younger age at transplantation is a risk factor for developing de novo post-transplant food allergy (dnPTFA)
  • Tacrolimus has been implicated as a risk factor for dnPTFA
  • Common dnPTFA are the same as in the general population: milk, egg, wheat, peanouts/nuts, fish, and soy

Management recommendations:

  • If the donor has a food allergy, the recipient should be tested within the first months of transplant for food-specific IgE and “it is advisable to introduce the suspected food in a controlled setting”
  • Elimination diet is mainstay of treatment. Some individuals may need modification of their immunosuppressive medications
  • Provide self-injectable epinephrine in those with food allergy
  • Monitoring of specific IgE/skin prick tests is advised

My take: There are increased allergy issues in kids who have had liver transplantation.

Related blog post: Lots of Allergy & Autoimmunity Issues Following Solid Organ Transplantation

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