Young children who had undergone liver transplant can develop food allergies. But, data are limited regarding clinical characteristics and patient outcomes. A recent study assessed pediatric liver transplant patients for a 16-year period and the food allergy incidence was observed to be 8% (19/236 patients). All patients with food allergies were <18 months old and the occurrence in this age group was 19.2% (19/99). Two patients among them had a single food allergy and 17 patients had multiple food allergies. In all, 5 patients presented with only non-IgE-mediated food allergies. Eggs, milk, wheat and nuts were the most common allergens observed. The presenting symptoms in these patients included diarrhea, vomiting, flushing, angioedema attacks, wheezing or chronic cough. Seven patients were infected with EBV and two other patients had CMV infections at the time of diagnosis of food allergy. Eosinophilia was seen in 12 patients. Seven patients (36.8%) were able to recover tolerance to all food allergens. But, one patient with single nut allergy and three other patients with multiple food allergies were on allergen-eliminated diets. Eight patients with multiple food allergies also gained tolerance for few food allergens. It is concluded that food allergies in children who underwent liver transplant were predominantly against multiple foods and IgE mediated. Infections like EBV and CMV might play a role in food allergies after liver transplant, especially in pre-transplant-naive patients.

Source: Barış Z, Köksal B, Özbek Ö, Özçay F, Haberal M. Incidence, clinical features, and outcomes of food allergy in children who underwent liver transplant: 16-year experience. Pediatr Transplant. 2019;23(4):e13399. doi:10.1111/petxr.13399