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The Acquisition of Food Allergy in Children after Liver Transplantation

      Rationale

      The acquisition of food allergy (FA) has been described mainly after liver transplantation in children. However, the precise pathogenesis remains uncertain. This study sought to identify the incidence and risk factors of food allergy in post liver-transplanted children.

      Methods

      This study was a retrospective analysis of pediatric liver transplant recipients in our hospital. We reviewed the medical records of all patients who underwent liver transplantation during study period. Data collected including age at liver transplantation, immunosuppressive drugs, causal allergens, type of allergic manifestations, preceding-hepatic diseases and etc.

      Results

      Between November 2005 and May 2010, 106 children received liver transplantation. The most common indication for liver transplantation was biliary atresia. Fifteen patients (10 female and 5 male) developed new-onset FA (14.2%). The average age at transplantation was 10 months and FA has been developed within 2 years. All patients received immunosuppressive therapy based on tacrolimus regimen. Allergic manifestations were as follows: urticaria and angioedema (80%) or gastrointestinal symptoms (50%). Non-IgE-mediated gastrointestinal allergy was suspected in two patients. Most common allergen was egg (50%). Eleven patients with BA (23.4%) and 4 patients with the other conditions (6.8%) developed new-onset FA (P = 0.023).

      Conclusions

      This study suggested that new-onset food allergy after liver transplantation is clinically important problem, especially during infancy and early childhood. We observed a trend toward an excess of FA in patients with biliary atresia compared to patients with other indications for liver transplantation. The risk management is needed to prevent life-threatening events in this population.