Patient develops peanut allergy after lung transplant: Case Report

A case report published in the journal Transplantation Proceedings reports the case of a 53-year-old woman, who developed a severe allergic reaction to peanut after lung transplantation. Surprisingly the allergy was acquired from the donor who had supplied the woman with a transplanted lung. The patient had no history of allergies to peanuts or other nuts before her transplant.

Two weeks after the transplant, the patient developed acute respiratory failure immediately after consuming peanut butter and jelly sandwich.

The woman in the case had needed a single-lung transplant to treat her emphysema, a condition in which the air sacs in the lungs become damaged, making it difficult to breathe. She received a new left lung from a 22-year-old male donor.

The woman's recovery was going well after the transplant, but the day before she was scheduled to go home from the hospital, she felt tightness in her chest and found it very difficult to breathe, according to the report. Initially, her doctors weren't sure why she was experiencing these symptoms of respiratory failure, and tests done at the time didn't turn up any clear explanation for it.

It wasn't until the woman mentioned that her symptoms started immediately after she had eaten a PB & J sandwich that doctors began to suspect a food allergy, even though the woman lacked other common allergy symptoms, such as a rash or stomachache.

Because the woman had never had problems eating peanuts before, doctors contacted the transplant agency, who confirmed that the male donor had a known peanut allergy, according to the case report.

Although it's rare for food allergies to be transferred from organ donors to transplant recipients, it does occur: cases of food allergies being acquired from organ donors have been reported after liver, kidney, lung, bone marrow, heart and kidney transplants, the authors wrote.

But not every transplant recipient who obtains an organ from a donor with food allergies picks up the sensitivity, which may turn up anywhere from days to months after the transplant. Studies have suggested, for example, that children and people who receive liver transplants may be more likely to develop food allergies from organ donors who have them.

Other research has shown that transplant-acquired food allergies occur more frequently when organ recipients are prescribed tacrolimus, an immunosuppressive drug used to reduce the risk of organ rejection following a transplant. The woman, in this case, had been on tacrolimus.

Skin tests later confirmed that the woman was allergic to peanuts, and she also tested positive for almonds, cashews, coconuts, and hazelnuts. Doctors advised her to avoid peanuts and tree nuts, and she was given an EpiPen in case of another severe allergic reaction to these foods.

"This case illustrates the importance of considering donor food allergies when caring for solid organ transplant recipients," concluded the authors.

For further reference follow the link: https://doi.org/10.1016/j.transproceed.2018.08.001