Topal Erdem, Çatal Ferhat, Selimoğlu Mukadder Ayşe, Karabiber Hamza, Klc Talat, Başkran Adil, Senbaba Elif, Ylmaz Sezai
Departments of aPediatric Allergy and Asthma bPediatric Gastroenterology and Hepatology cPulmonary Medicine dLiver Transplant Institute, Turgut Ozal Medical Center, Inonu University Faculty of Medicine, Malatya, Turkey.
Eur J Gastroenterol Hepatol. 2014 Sep;26(9):1055-9. doi: 10.1097/MEG.0000000000000142.
The aim of this study was to determine the similarities and differences in the frequency and follow-ups of newly diagnosed atopic diseases after liver transplantation in pediatric and adult patients.
Patients who underwent liver transplants between 2005 and 2013 and who are still alive were enrolled in the study. Patients who came for checkups filled out a survey evaluating atopic diseases. Those who had an atopic disease before transplantation were excluded from the study.
A total of 165 patients were enrolled in this study; 114 (69.1%) were males and 29 (17.6%) were children. The average transplantation age was 40.8 (0.3-67) years, and the most frequent reason for transplantation was chronic viral hepatitis. In 22 patients, atopic diseases [allergic rhinitis in nine patients (5.5%), asthma in six patients (3.9%), atopic eczema in six patients (3.9%), food allergy in six patients (3.9%), and drug allergy in one patient (0.6%)] developed after transplantation. Atopic diseases after transplantation were more common in children (P=0.03). When the atopic diseases were examined on a case-by-case basis, there were no differences between children and adults with respect to asthma (P=0.284), allergic rhinitis (P=1.0), or atopic eczema (P=0.284), but food allergy (P=0.009) and peripheral eosinophilia (P=0.002) were more common in children. The periodicity of allergic diseases after transplantation (P=0.192) and total IgE levels (P=0.086) were similar.
Atopic diseases developed after liver transplantation and had a greater impact on children than adults. Therefore, after undergoing liver transplantation, patients should be monitored closely for signs of atopic diseases.
本研究旨在确定儿童和成人肝移植后新诊断的特应性疾病在发病率及随访方面的异同。
选取2005年至2013年间接受肝移植且仍存活的患者纳入研究。前来体检的患者填写一份评估特应性疾病的调查问卷。移植前患有特应性疾病的患者被排除在研究之外。
本研究共纳入165例患者；其中114例（69.1%）为男性，29例（17.6%）为儿童。平均移植年龄为40.8（0.3 - 67）岁，最常见的移植原因是慢性病毒性肝炎。22例患者在移植后出现了特应性疾病[9例（5.5%）患过敏性鼻炎，6例（3.9%）患哮喘，6例（3.9%）患特应性湿疹，6例（3.9%）患食物过敏，1例（0.6%）患药物过敏]。移植后特应性疾病在儿童中更常见（P = 0.03）。逐一检查特应性疾病时，儿童和成人在哮喘（P = 0.284）、过敏性鼻炎（P = 1.0）或特应性湿疹（P = 0.284）方面无差异，但食物过敏（P = 0.009）和外周嗜酸性粒细胞增多（P = 0.002）在儿童中更常见。移植后过敏性疾病的发作周期（P = 0.192）和总IgE水平（P = 0.086）相似。
肝移植后会出现特应性疾病，且对儿童的影响大于成人。因此，肝移植后患者应密切监测特应性疾病的迹象。
