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Wednesday, May 16, 2007

Allergy Donors NOT Wanted

NoPeanutsPlease was recently quoted on another blog and it generated over 100 visits in just three days. I was impressed. The blog's author, Moreena, has a challenging parenting situation in that her six year old daughter has had multiple liver transplants and often has a suppressed immune system, which presents a significant risk for infection. Frankly, managing a severe peanut allergy seems to be somewhat less of a challenge, though being thorough and prepared is likely a consistent theme for both groups of parents.

In an off-blog exchange with Moreena, she noted that she became familiar with allergy discussion boards due to the number of transplant recipients that also inherit a food allergy from their donor. This reminded me of an article last week about a Scottish woman who picked up a severe peanut allergy via blood transfusion.

It never occurred to me that this would be a risk but it does make total sense given that the IgE antibody is found in blood serum. It seems that the antibody is able to make itself right at home in new surroundings! Here is an excerpt from the article:

"It is believed to be the first time a severe food allergy has passed from one person to another through donated blood. The 80-year-old patient was given blood ahead of minor surgery ... Two days later she ate a muffin with peanut butter and became ill within minutes with anaphylactic shock. Her throat closed, she was struggling for breath and she had difficulty swallowing. Doctors immediately injected her with adrenaline and steroids to halt the potentially fatal reaction.

"... When they checked the records, they found the blood had come from a 19-year-old female patient with a history of severe allergic reactions to nuts ... The National Blood Service said it does not test donated blood for allergies. Allergy sufferers are allowed to give blood as long as they are not suffering any symptoms on the day."

I find it incredible that this has not been recorded before, especially given that the Prausnitz-K├╝stner reaction was documented 85 years ago! I wonder how many adults who 'developed allergies later in life' actually received them via a blood transfusion or organ transplant? I suspect not all of them but it does beg the question.

Seems that screening would be a good idea. An amazing future scenario might see an organ recipient being forced to choose between waiting for a matching organ that is allergy free, but might never arrive, or accepting an available organ from a donor who has severe anaphylaxis to five or more major allergens. I suspect in just about every case the patient would still take the organ, but it does present an interesting medical quandary.

Sometimes I am struck by how little we know about severe food allergies. Our lack of information is simply unfathomable. Though I am not enamoured with the circumstances of my involvement in this issue, I have to admit that I find anaphylaxis to be absolutely fascinating.

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