ORGAN transplantation is a critical intervention for children suffering from end-stage organ failure. However, this life-saving procedure has been associated with the emergence of post-transplant allergies, particularly food allergies, known as transplant-acquired food allergy (TAFA). This phenomenon is increasingly recognized in the medical community, yet its underlying mechanisms remain poorly understood.
Paediatric transplant recipients typically require lifelong immunosuppressive therapy to prevent graft rejection, which can disrupt normal immune function and elevate the risk of developing allergic reactions. Recent research aims to gather and evaluate the latest evidence regarding TAFA and its implications for affected patients.
Food allergies (FAs) represent a significant global health issue, impacting approximately 5–10% of the population, with a particularly rising prevalence in developed countries. These allergies can manifest in various clinical symptoms, ranging from mild discomfort to severe, potentially life-threatening reactions. The increasing occurrence of FAs poses challenges for healthcare systems, prompting ongoing research into their prevention, diagnosis, and management. The link between organ transplants and the development of allergies, especially in paediatric patients, is an area of growing interest. Epidemiological studies indicate that FAs are notably prevalent among Paediatric liver transplant recipients, with rates ranging from 5.6%–38%. These allergies often develop within the first year following the transplant, with common triggers including eggs, soy, wheat, and peanuts.
Paediatric transplant recipients frequently experience other allergic conditions such as asthma and rhinitis, suggesting a broader spectrum of immune dysregulation. The development of TAFAs introduces significant complexities, as these allergies not only pose health risks but also lead to emotional and economic burdens for affected individuals and their families. Research indicates that immunosuppressive therapies, particularly the use of tacrolimus, may contribute to increased allergic sensitisation and altered intestinal permeability.
While organ transplantation is a life-saving intervention, the associated risk of developing food allergies, particularly in paediatric liver transplant recipients, necessitates further investigation. Understanding the mechanisms behind TAFA development could lead to targeted interventions to mitigate this risk and continued research into TAFA and its relationship with the microbiome and immunosuppressive therapies is crucial for supporting the long-term health and quality of life of Paediatric transplant patients.
Katie Wright, EMJ
Reference
Indolfi C et al. Transplant-acquired food allergy in children. Nutrients. 2024;16(18):3201.
