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Post-transplant food allergy in children is associated with liver and not with renal transplantation: A monocentric comparative study

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Abstract

Food allergy is increasingly reported after paediatric liver transplantation. The underlying physiopathological mechanism remains incompletely understood. Therefore, we aimed to determine the incidence, clinical presentation, possible risk factors, and prognosis of post-transplant food allergy in children currently followed after liver and renal transplantation. The study population consists of 49 liver and 21 renal transplant patients transplanted between the age of 22 months and 15 years. Data were collected retrospectively from medical records and via a doctor’s questionnaire taken from the parents in a monocentric setting. Post-transplant food allergy has developed in 13 liver transplant patients and in none of the renal transplant recipients. Within the liver transplant group, median age at liver transplantation is significantly lower in the food-allergic (10 months) versus non-food-allergic group (3.3 years; p = 0.002). The use of tacrolimus as primary maintenance immunosuppression is associated with food allergy (p = 0.032) and mean donor age is significantly lower in the food-allergic group (p = 0.009). Compared to the renal transplant group, median age at transplantation is significantly lower in the liver patients (p < 0.001). No significant differences are found in primary immunosuppressive regimens between renal and liver transplant patients. Conclusion: Post-transplant food allergy is an important clinical problem in children after liver transplantation which does not affect renal transplant patients despite similar immunosuppressive regimens. Within the group of liver transplant recipients, tacrolimus use, young age at time of transplant and younger donor age were associated with the development of food allergy.

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Abbreviations

ALF:

Acute liver failure

CMP:

Cow’s milk protein

EE:

Eosinophilic oesophagitis

EHBA:

Extrahepatic biliary atresia

FTT:

Failure to thrive

LTx:

Liver transplantation

NP:

Not performed

PFIC:

Progressive familial intrahepatic cholestasis

PN:

Parenteral nutrition

sIgE:

Specific IgE

SPT:

Skin prick testing

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Acknowledgments

We thank Karen Robben and Sarah Vanderplaetsen for their assistance in data collection. Philippe Gevaert, Melissa Dullaers and Ruth De Bruyne have a grant as resp. senior clinical investigator, postdoctoral fellow and clinical Ph.D. fellow by the Flemish Scientific Research Board (FWO Vlaanderen).

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Authors and Affiliations

  1. Department of Paediatric Gastroenterology, Hepatology and Nutrition, Princess Elisabeth Children’s Hospital, Ghent University Hospital, Belgium De Pintelaan 185, 9000, Ghent, Belgium

    Ruth De Bruyne, Stephanie Van Biervliet, Saskia Vande Velde & Myriam Van Winckel

  2. Laboratory of Immunoregulation and Mucosal Immunology, Department of Pulmonary Medicine, Ghent University Hospital, Ghent, Belgium

    Melissa Dullaers

  3. Department of Paediatric Nephrology, Princess Elisabeth Children’s Hospital, Ghent University Hospital, Ghent, Belgium

    Ann Raes

  4. Upper Airways Research Laboratory, Department of Otorhinolaryngology, Ghent University Hospital, Ghent, Belgium

    Philippe Gevaert

Authors
  1. Ruth De Bruyne
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  2. Melissa Dullaers
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  3. Stephanie Van Biervliet
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  4. Saskia Vande Velde
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  5. Ann Raes
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  6. Philippe Gevaert
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  7. Myriam Van Winckel
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Correspondence to Ruth De Bruyne.

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De Bruyne, R., Dullaers, M., Van Biervliet, S. et al. Post-transplant food allergy in children is associated with liver and not with renal transplantation: A monocentric comparative study. Eur J Pediatr 172, 1069–1075 (2013). https://doi.org/10.1007/s00431-013-2002-y

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  • DOI: https://doi.org/10.1007/s00431-013-2002-y

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