What is liver transplant acquired food allergy (LTAFA)?
The acquisition of new food allergy after orthotopic liver transplantation is now a well described phenomenon, mainly reported in children. The etiology of this phenomenon is at present unclear, but has been associated with immunosuppressive treatment with tacrolimus. However, tacrolimus treatment alone cannot account for liver transplant acquired food allergy (LTAFA)
How common is newly acquired food allergy in children who received liver transplants?
An abstract presented at the 2012 Annual Meeting of the American Academy of Allergy, Asthma & Immunology (AAAAI) found that about 14% of children in the studied sample acquired new food allergy with egg being the most typical allergen.
Researchers from the National Center for Child Health and Development in Tokyo, Japan, reviewed the medical records of all 106 pediatric patients who received a liver transplant in its hospital during 5 years (2005-2010).
The most common reason for the transplant was biliary atresia, which is a congenital condition that causes a blockage in the tubes that carry bile from the liver to the gallbladder.
Approximately 14% of the children (10 females and 5 males) in the sample developed new onset food allergy. The average age at transplantation was 10 months and food allergy was found to be developed within two years.
All of the patients had been given tacrolimus for immunosuppressive treatment.
”The common scenario for the development of food allergy after liver transplantation is young children who are on a regimen of tacrolimus after receiving a liver from a non-allergic donor*,” commented first author Tetsuo Shoda, MD. “There might be unknown factors specific to liver transplantation, because only few reports have described food allergy after transplantation of other solid organs, such as the kidney or heart.”
For those patients who developed food allergy, 80% had hives and angioedema as symptoms and 50% presented with gastrointestinal symptoms. Egg was the most common newly acquired allergy, found in 50% of the children. Frequent operations might play a role in generating the food allergy.
The development of food allergy after liver transplantation. Boyle RJ, Hardikar W, Tang ML. Liver Transpl. 2005 Mar;11(3):326-30.
How common is newly acquired food allergy in children who received liver transplants? AAAAI, 2012.