Levy Yael, Davidovits Miriam, Cleper Roxana, Shapiro Rivka
Kipper Institute of Immunology, Schneider Children's Medical Center of Israel, Petach Tikva, Israel.
Pediatr Transplant. 2009 Feb;13(1):63-9. doi: 10.1111/j.1399-3046.2007.00883.x. Epub 2007 Dec 30.
New-onset post-transplantation food allergy has been described mainly after liver transplantation, and its pathogenesis was attributed to the immunomodulatory effects of tacrolimus therapy. The aim of the present study was to evaluate the association of food allergy with solid organ transplantation in our center. The medical records of children who underwent kidney transplantation and children who underwent liver or liver and kidney transplantation from 1986 to 2005 were reviewed. A total of 189 children (124 after kidney transplantation, 65 after liver or liver and kidney transplantation) received tacrolimus as part of the immunosuppressive regimen. New-onset post-transplantation food allergy was documented in four of them: two with liver transplants and two with combined kidney and liver transplants. The absence of new-onset food allergy in the children with isolated kidney transplants is compatible with other reports in the literature. This study supports the concept that the functioning liver itself, and not only tacrolimus immunosuppression, is a main contributor to food allergy in this patient population.
移植后新发食物过敏主要在肝移植后被描述，其发病机制归因于他克莫司治疗的免疫调节作用。本研究的目的是评估在我们中心食物过敏与实体器官移植之间的关联。回顾了1986年至2005年期间接受肾移植的儿童以及接受肝移植或肝肾联合移植的儿童的病历。共有189名儿童（124名肾移植后儿童，65名肝移植或肝肾联合移植后儿童）接受了他克莫司作为免疫抑制方案的一部分。其中有4例记录了移植后新发食物过敏：2例肝移植患儿和2例肝肾联合移植患儿。孤立肾移植患儿未出现新发食物过敏这一情况与文献中的其他报道相符。本研究支持这样一种观点，即在该患者群体中，发挥功能的肝脏本身，而不仅仅是他克莫司免疫抑制，是食物过敏的主要促成因素。
