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儿童肝移植后食物过敏发展的相关因素:10 年经验的回顾性分析。

Factors Associated with Development of Food Allergy in Young Children after Liver Transplantation: A Retrospective Analysis of 10 Years' Experience.

机构信息

Division of Allergy, Department of Medical Subspecialties, National Center for Child Health and Development, Tokyo, Japan.

Division of Allergy, Department of Medical Subspecialties, National Center for Child Health and Development, Tokyo, Japan.

出版信息

J Allergy Clin Immunol Pract. 2017 Nov-Dec;5(6):1698-1706. doi: 10.1016/j.jaip.2017.04.013. Epub 2017 May 24.

Abstract

BACKGROUND

Although development of food allergy after liver transplantation is most commonly described in young children, little is known about identification of young liver-transplant recipients who are at risk of food allergy.

OBJECTIVE

This study aimed to identify the types of food allergy and the risk factors for the development of food allergy after liver transplantation.

METHODS

This was a retrospective analysis of pediatric liver transplant recipients in our organ transplantation center during 2005-2015. Relevant data of all patients who underwent liver transplantation were extracted from the center's database and the medical records. Differences in patients' characteristics were evaluated for associations between food allergy and potential risk factors. Logistic regression models were used to calculate adjusted odds ratios.

RESULTS

We obtained the data of 206 patients under 36 months of age, 42 (20.4%) of whom developed food allergy after liver transplantation. The allergy was IgE-mediated-only in 30 (71.4%) and non-IgE-mediated-only in 10 (23.8%). Multivariate analysis found eczema at liver transplantation to be a significant risk factor (adjusted odds ratio [aOR] 2.41, 95% confidence interval [CI] 1.14-4.77, P < .05). Eczema increased the risk of developing IgE-mediated food allergy after liver transplantation (aOR 3.13, 95% CI 1.41-6.93, P < .01), whereas no significant association was observed with non-IgE-mediated food allergy.

CONCLUSIONS

We identified eczema at liver transplantation as a significant risk factor for the development of IgE-mediated food allergy after liver transplantation, but not non-IgE-mediated food allergy. Our findings may contribute to a better understanding of the susceptible subgroup requiring special caution and to the establishment of effective strategies for prevention.

摘要

背景

尽管肝移植后食物过敏的发展在幼儿中最为常见,但对于易发生食物过敏的年轻肝移植受者的识别知之甚少。

目的

本研究旨在确定肝移植后食物过敏的类型和危险因素。

方法

这是对我们器官移植中心 2005-2015 年期间进行的小儿肝移植受者的回顾性分析。从中心数据库和病历中提取所有接受肝移植患者的相关数据。评估患者特征的差异,以确定食物过敏与潜在危险因素之间的关联。使用逻辑回归模型计算调整后的优势比。

结果

我们获得了 206 名年龄在 36 个月以下的患者的数据,其中 42 名(20.4%)在肝移植后发生食物过敏。过敏仅为 IgE 介导的有 30 例(71.4%),仅为非 IgE 介导的有 10 例(23.8%)。多变量分析发现肝移植时的湿疹是一个显著的危险因素(调整后的优势比[aOR]2.41,95%置信区间[CI]1.14-4.77,P<.05)。湿疹增加了肝移植后发生 IgE 介导的食物过敏的风险(aOR 3.13,95% CI 1.41-6.93,P<.01),而非 IgE 介导的食物过敏则无显著相关性。

结论

我们发现肝移植时的湿疹是肝移植后发生 IgE 介导的食物过敏的一个显著危险因素,但不是非 IgE 介导的食物过敏。我们的发现可能有助于更好地了解需要特别注意的易感亚组,并制定有效的预防策略。

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