Amin J. Roberts, MD

Pediatric liver transplant recipients were found to be more likely than adult recipients to acquire transplant-acquired atopy and allergy (TAA) with female gender also being correlated with higher rates according to new findings.¹

The investigators found that the most common disorders are eczema and IgE-mediated allergy and that the most common allergens are peanuts and tree nuts.

The study’s investigators were led by Amin J. Roberts, MD, of Starship Child Health’s Department of Paediatric Gastroenterology in New Zealand.

“There are increasing reports of atopy/allergy following solid organ transplantation, especially paediatric liver transplantation (LT) with minimal New Zealand (NZ) data,” Roberts and colleagues wrote. “We describe the prevalence of transplant-acquired atopy and allergy (TAA) in NZ paediatric liver transplant recipients, compared to paediatric kidney and adult liver transplants.”

Background

The researchers used a 15-year, retrospective review of pediatric liver, pediatric kidney, and adult liver transplant patients whose procedures had been conducted in the period between January of 2003 and December of 2017.

They were able to find patients through the New England transplant registry, excluding those with multi-visceral operations from their research.

The transplants of both age groups were completed at both Starship Child Health and Auckland City Hospital, with pediatric patients in the former and adults in the latter.

The research team posted questionnaires to the transplant patients and their families on atopy and food-related health questions, along with consent forms.

After 2 weeks, the team sent the study participants follow-up phone calls in which the same questionnaire was discussed with the patients, with questions including severity and management of post-transplant TAA development.

Findings

In total, 232 patients consented to participate in the study and had their data included in the team’s final analysis, with 39 being pediatric kidney, 82 being pediatric liver, and 111 being adult liver recipients.

The investigators concluded that being of the female gender and being younger were both factors that led to increased the likelihood of TAA in the study participants.

Of those who ended up with TAA, the team noted that the number was substantially higher (P < 0.001) in the pediatric liver recipient group (36/82) when compared to both pediatric kidney recipients (4/39) and to the adult liver recipients (12/111).

The investigators added that among every patient, eczema was the most common disorder (73%), followed by IgE-mediated food allergy (33%), then allergic rhinitis (19%), and then asthma (17%).

Among the pediatric liver transplant patients, those who were female and of a younger age bracket by the time of their transplants had higher likelihoods of getting TAA.

“TAA is common in paediatric liver transplant recipients, with female gender and younger age at transplant being risk factors identified,” they wrote. “This highlights the need for detailed atopic and allergy history to be incorporated in all pre-transplant assessments.”

References:

1. Roberts, A.J., et al. (2023), Atopy and allergy following solid organ transplantation: A 15-year experience. J Paediatr Child Health. https://doi.org/10.1111/jpc.16349.