Transplant patient got nut allergy from liver

Published: Tuesday, January 28, 2003 at 6:01 a.m.
Last Modified: Tuesday, January 28, 2003 at 12:27 a.m.


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CHICAGO - A man who received a liver transplant got a life-threatening nut allergy from the new organ, Australian doctors say.
The organ had come from a 15-year-old boy who died of an allergic reaction to peanuts, the doctors reported in Monday's Archives of Internal Medicine.
Dr. Tri Giang Phan, an immunology specialist at Sydney's Royal Prince Alfred Hospital who was involved in the case, said he knew of only one other report in medical literature of an allergy being passed on in an organ transplant. That incident, reported by French doctors in 1997, involved a man who developed a peanut allergy after a liver and kidney transplant.
While such cases may be rare, organ donors should be screened for allergies and transplant patients should be warned to take precautions, the Australian researchers said.
Nut allergies affect close to 3 million Americans. Such allergies generally would be noted during the organ procurement process, which involves obtaining information on the donor's health history, said Dr. Douglas Hanto of the United Network for Organ Sharing.
The 60-year-old Australian transplant patient and his doctors did not know about the boy's condition, which had not been formally diagnosed as a nut allergy, Phan said.
The man's own liver was sickened by chronic hepatitis B and a cancerous tumor. He underwent the transplant at the Sydney hospital in 1999. The day after being sent home, he ate some cashews. Within 15 minutes he developed anaphylaxis - a life-threatening allergic reaction causing tightness in the throat, severe vomiting, dizziness and blurred vision.
He recovered after hospitalization and drug treatment.
Tests showed that he had an allergy to cashews, peanuts and sesame seeds - all foods to which the boy had also been allergic. The reaction probably developed because the man's new liver contained allergy-inducing antibodies, Phan said.
About 11 months after his transplant, the man underwent more tests that suggested his allergy was waning, but he died two years after the operation from complications related to the liver tumor, Phan said.

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