Patients studied for transfer of allergy after solid organ transplantation
| Source, demographics, disease . | Transplantation . | Allergy status*† . | Follow-up . | IS‡ . | Chimerism . | Transferdocumented conclusively? . | ||
|---|---|---|---|---|---|---|---|---|
| Donor . | Pretransplantation recipient . | Posttransplantation recipient§ . | ||||||
| Phan et al34 | ||||||||
| 1a. 60 yo male; cirrhosis, hepatitis-B, hepatoma | Liver | CM: eczema, asthma, anaphylaxis after ingesting nuts;T-IgE: 15 000 kU/L;A-IgE: “high” for peanut and cashew (by RAST?) | CM: none; T-IgE: 18 kU/L;A-IgE: NR | CM: throat tightness, vomiting and diarrhea after ingesting nuts; T-IgE: 12 kU/L;A-IgE: negative (by RAST?) for peanut and cashew. SPT positive for peanut and cashew. | 11 mo | AZA, corticosteroids, Tacro | Only recipient cells detected in blood. | No‖ |
| 1b. NR | Kidney | Same as above | CM: NR;T-IgE: NR;A-IgE: NR | CM: None | 11 mo | NR¶ | NR | N/A |
| 1c. NR | Kidney and pancreas | Same as above | CM: NR;T-IgE: NR;A-IgE: NR | CM: None | 11 mo | NR¶ | NR | N/A |
| Trotter et al35 | ||||||||
| 2a. 28 yo female; cirrhosis | Liver-kidney | CM: asthma, anaphylaxis after ingesting peanuts;T-IgE: NR; A-IgE: NR | CM: None;T-IgE: NR;A-IgE: NR | CM: hives/rash/itching after ingesting peanuts. T-IgE: NRA-IgE: negative (by FEIA) for peanut. SPT positive for peanut. | 28 d | CSA, corticosteroids | NR | No‖ |
| 2b. NR | Kidney | Same as above | CM: NR; T-IgE: NR;A-IgE: NR | CM: None T-IgE: NRA-IgE: NR | 28 d | NR¶ | NR | N/A |
| 2c. NR | Kidney-pancreas | Same as above | CM: NR T-IgE: NRA-IgE: NR | CM: None T-IgE: NRA-IgE: NR | 28 d | NR¶ | NR | N/A |
| 2d. NR | Heart | Same as above | CM: NR T-IgE: NRA-IgE: NR | CM: None T-IgE: NRA-IgE: NR | 28 d | NR¶ | NR | N/A |
| Legendre et al36 | ||||||||
| 3a. 35 yo male; ESRD due to glomerulo-nephritis; cirrhosis due to hepatitis C | Liver-kidney | CM: anaphylaxis after ingesting peanuts; T-IgE: NR;A-IgE: “high” for peanuts (by RAST). | CM: noneT-IgE: NR;A-IgE: negative for peanuts. | CM: rash and dyspnea after ingesting peanuts. T-IgE: NR. A-IgE: positive for peanuts (by RAST?). | 3 mo | OKT3, CSA, AZA, corticosteroids | “Micro-chimerism” in skin, only recipient cells detected in blood | Yes |
| 3b. 27 yo female; ESRD due to type 1 diabetes mellitus | Kidney-pancreas | Same as above | CM: NRT-IgE: NRA-IgE: NR | CM: none. nonallergic to peanuts by oral challenge.T-IgE: NRA-IgE: negative for peanuts (by RAST?). | 3 mo | OKT3, CSA, AZA, corticosteroids | Only recipient cells detected in both skin and blood. | N/A |
| Source, demographics, disease . | Transplantation . | Allergy status*† . | Follow-up . | IS‡ . | Chimerism . | Transferdocumented conclusively? . | ||
|---|---|---|---|---|---|---|---|---|
| Donor . | Pretransplantation recipient . | Posttransplantation recipient§ . | ||||||
| Phan et al34 | ||||||||
| 1a. 60 yo male; cirrhosis, hepatitis-B, hepatoma | Liver | CM: eczema, asthma, anaphylaxis after ingesting nuts;T-IgE: 15 000 kU/L;A-IgE: “high” for peanut and cashew (by RAST?) | CM: none; T-IgE: 18 kU/L;A-IgE: NR | CM: throat tightness, vomiting and diarrhea after ingesting nuts; T-IgE: 12 kU/L;A-IgE: negative (by RAST?) for peanut and cashew. SPT positive for peanut and cashew. | 11 mo | AZA, corticosteroids, Tacro | Only recipient cells detected in blood. | No‖ |
| 1b. NR | Kidney | Same as above | CM: NR;T-IgE: NR;A-IgE: NR | CM: None | 11 mo | NR¶ | NR | N/A |
| 1c. NR | Kidney and pancreas | Same as above | CM: NR;T-IgE: NR;A-IgE: NR | CM: None | 11 mo | NR¶ | NR | N/A |
| Trotter et al35 | ||||||||
| 2a. 28 yo female; cirrhosis | Liver-kidney | CM: asthma, anaphylaxis after ingesting peanuts;T-IgE: NR; A-IgE: NR | CM: None;T-IgE: NR;A-IgE: NR | CM: hives/rash/itching after ingesting peanuts. T-IgE: NRA-IgE: negative (by FEIA) for peanut. SPT positive for peanut. | 28 d | CSA, corticosteroids | NR | No‖ |
| 2b. NR | Kidney | Same as above | CM: NR; T-IgE: NR;A-IgE: NR | CM: None T-IgE: NRA-IgE: NR | 28 d | NR¶ | NR | N/A |
| 2c. NR | Kidney-pancreas | Same as above | CM: NR T-IgE: NRA-IgE: NR | CM: None T-IgE: NRA-IgE: NR | 28 d | NR¶ | NR | N/A |
| 2d. NR | Heart | Same as above | CM: NR T-IgE: NRA-IgE: NR | CM: None T-IgE: NRA-IgE: NR | 28 d | NR¶ | NR | N/A |
| Legendre et al36 | ||||||||
| 3a. 35 yo male; ESRD due to glomerulo-nephritis; cirrhosis due to hepatitis C | Liver-kidney | CM: anaphylaxis after ingesting peanuts; T-IgE: NR;A-IgE: “high” for peanuts (by RAST). | CM: noneT-IgE: NR;A-IgE: negative for peanuts. | CM: rash and dyspnea after ingesting peanuts. T-IgE: NR. A-IgE: positive for peanuts (by RAST?). | 3 mo | OKT3, CSA, AZA, corticosteroids | “Micro-chimerism” in skin, only recipient cells detected in blood | Yes |
| 3b. 27 yo female; ESRD due to type 1 diabetes mellitus | Kidney-pancreas | Same as above | CM: NRT-IgE: NRA-IgE: NR | CM: none. nonallergic to peanuts by oral challenge.T-IgE: NRA-IgE: negative for peanuts (by RAST?). | 3 mo | OKT3, CSA, AZA, corticosteroids | Only recipient cells detected in both skin and blood. | N/A |
NR indicates not reported; yo, years old; CSA, cyclosporin A; AZA, azathioprine; Tacro, tacrolimus; ESRD, end-stage renal disease; FEIA, fluorescent enzymoimmunoassay; CM, clinical manifestation; T-IgE, total IgE; and A-IgE, allergen- specific IgE.
Total serum IgE (suggestive but not diagnostic of allergy), typical reference value, less than 300 IU/mL.
Allergen-specific IgE (diagnostic of allergy if present in a person with clinical manifestations of allergic disease). Typical reference value is less than 0.35 kU/L or RAST score 0 (scale 0-4).
Pharmacologic immunosuppression.
If allergy status evaluation was done at multiple time points after transplantation, the data shown in the table is for the time point when most prominent allergic reactions were observed.
Presumably given as life-long IS therapy is typically given to solid organ transplant recipients.
Reason for the inconclusiveness of transfer in patients 1a and 2a: recipient pretransplantation allergen-specific IgE was not studied.