Department of Woman, Child and of General and Specialized Surgery, University of Campania Luigi, Vanvitelli, 80138 Naples, Italy.
Nutrients. 2024 Sep 22;16(18):3201. doi: 10.3390/nu16183201.
Organ transplantation in children is a vital procedure for those with end-stage organ failure, but it has been linked to the development of post-transplant allergies, especially food allergies. This phenomenon, known as transplant-acquired food allergy (TAFA), is becoming increasingly recognized, though its mechanisms remain under investigation. Pediatric transplant recipients often require lifelong immunosuppressive therapy to prevent graft rejection, which can alter immune function and heighten the risk of allergic reactions. Our review aimed to gather the latest evidence on TAFA.
We conducted a PubMed search from 25 June to 5 July 2024, using specific search terms, identifying 143 articles. After screening, 36 studies were included: 24 retrospective studies, 1 prospective study, 2 cross-sectional researches, and 9 case reports/series.
Most studies focused on liver transplants in children. The prevalence of food allergies ranged from 3.3% to 54.3%. Tacrolimus, alongside corticosteroids, was the most commonly used immunosuppressive therapy. In addition to food allergies, some patients developed atopic dermatitis, asthma, and rhinitis. Allergic symptoms typically emerged within a year post-transplant, with common allergens including milk, eggs, fish, nuts, soy, wheat, and shellfish. Both IgE-mediated and non-IgE-mediated reactions were observed, with treatment often involving the removal of offending foods and the use of adrenaline when necessary.
Consistent immunological monitoring, such as skin prick tests and IgE level assessments, is essential for early detection and management of allergies in these patients. Understanding the link between transplantation and allergy development is crucial for improving long-term outcomes for pediatric transplant recipients.
器官移植是治疗儿童末期器官衰竭的重要手段，但它与移植后过敏的发生有关，特别是食物过敏。这种现象被称为移植获得性食物过敏（TAFA），尽管其机制仍在研究中，但越来越受到重视。儿科移植受者通常需要终身免疫抑制治疗以预防移植物排斥反应，这可能改变免疫功能并增加过敏反应的风险。我们的综述旨在收集 TAFA 的最新证据。
我们于 2024 年 6 月 25 日至 7 月 5 日进行了 PubMed 检索，使用特定的搜索词，共识别出 143 篇文章。经过筛选，纳入 36 项研究：24 项回顾性研究、1 项前瞻性研究、2 项横断面研究和 9 项病例报告/系列。
大多数研究都集中在儿童肝移植上。食物过敏的患病率为 3.3%至 54.3%。他克莫司联合皮质类固醇是最常用的免疫抑制治疗方法。除食物过敏外，一些患者还出现特应性皮炎、哮喘和鼻炎。过敏症状通常在移植后一年内出现，常见的过敏原包括牛奶、鸡蛋、鱼、坚果、大豆、小麦和贝类。观察到 IgE 介导和非 IgE 介导的反应，治疗通常包括去除致敏食物和必要时使用肾上腺素。
对于这些患者，进行持续的免疫监测，如皮肤点刺试验和 IgE 水平评估，对于早期发现和管理过敏至关重要。了解移植与过敏发生之间的联系对于改善儿科移植受者的长期预后至关重要。
