The recipient of a donor liver and kidney apparently got more than he bargained for in the 1989 transplantation. He also inherited the donor's allergy to peanuts.
According to the September 18 issue of The New England Journal of Medicine (1997;337:822-824), the donor was a 22-year-old man with an allergy to peanuts who died after inadvertently eating satay sauce, which contains peanuts. The man's liver and right kidney were transplanted into a 35-year-old man, and his pancreas and left kidney were given to a 27-year-old woman, neither of whom were allergic to peanuts. Three months after the transplantation, the liver-kidney recipient was diagnosed with an allergy to peanuts based on "clinical findings; the absence of specific IgE antibodies before transplantation, their presence at the time the symptoms appeared, and their decline thereafter; and a positive basophil degranulation test," reported Christophe Legendre, MD, and his coauthors at two Paris hospitals.
However, the pancreas-kidney recipient showed no signs of allergy.
The recipient of the liver and kidney was told to avoid peanuts, and the donor organs continued to function well seven years after the transplant.
The authors reported that it "is relevant" that the allergy was transferred only in the patient who received the liver. Pluripotential hematopoietic stem cells and dendritic cells, which are found in the liver, can migrate to the lymphoid organs. In the recipient's case, the donor-derived cells migrated to his skin, and his allergy manifested as a skin rash.
"It is thus tempting to speculate that the passenger cells present in the donor liver, but not in his kidney or pancreas, were responsible for the transfer of the allergy to our patient," the authors noted.
For Your Information:
Christophe Legendre, MD
Service de Transplantation. Hôpital Necker, 161 rue de Sèvres, 75743, Paris CEDEX 15, France
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