Magazine article Science News

Liver Transplant Transfers Peanut Allergy

Magazine article Science News

Liver Transplant Transfers Peanut Allergy

Article excerpt

After eating a meal with satay sauce in a Paris restaurant, a 22-year-old man who is allergic to peanuts suffers cardiac arrest, falls into a coma, and is diagnosed as brain dead.

Being an organ donor, his liver and one kidney are transplanted into a 35-year-old man, who then recovers. The donor's pancreas and other kidney go to a 27-year-old woman, who also rebounds.

Three months later, however, the male recipient--who has no previous allergy to peanuts--breaks out in a rash after eating some of these legumes. Doctors treat him and then contact the woman, who reports no such episodes. Under close medical supervision, she eats some peanuts. Nothing happens.

This strange case, reported in the Sept. 18 New England Journal of Medicine, appears to be the first documented instance of a transplanted organ that imparted an allergy to its recipient. In earlier studies, transplanted bone marrow has been shown to transfer some allergies, apparently because bone marrow is rich in hematopoietic stem cells--immature cells whose daughters grow into red and white blood cells.

The new case draws attention to the liver, another source of these stem cells. The allergic reaction indicates a blending of the donor and recipient immune systems, the researchers suggest. Tests showed that donor-derived cells migrated from the liver to the recipient's skin and were working in league with his own immune system to form the rash.

Other tests solidified the immune system connection. Peanut-specific antibodies, which were plentiful in the blood of the dead man and absent from the recipient at the time of the operation, turned up in the recipient later, says study coauthor Christophe Legendre of St. Louis Hospital in Paris.

Some of the donor's lymphocytes, white blood cells that defend against intruders in the body, had been activated by peanuts, Legendre says. …

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