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De novo Food Allergy After Pediatric Liver Transplantation: A Systematic Review

BACKGROUND: Liver transplant (LT) recipients, particularly children, have an increased risk of developing de novo food allergies (FAs) after transplantation both compared to all the other transplant groups and to the general population. Little is known about the pathogenesis underlying this phenomen...

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Autores principales: Bergamo, Chiara, Argento, Emily Claire, Giampetruzzi, Stefania, Cutini, Maristella, Ciabattoni, Francesco, Faggian, Giovanna, Gaio, Paola, Bosa, Luca, Cananzi, Mara
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
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Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9134120/
https://www.ncbi.nlm.nih.gov/pubmed/35633971
http://dx.doi.org/10.3389/fped.2022.885942
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author Bergamo, Chiara
Argento, Emily Claire
Giampetruzzi, Stefania
Cutini, Maristella
Ciabattoni, Francesco
Faggian, Giovanna
Gaio, Paola
Bosa, Luca
Cananzi, Mara
author_facet Bergamo, Chiara
Argento, Emily Claire
Giampetruzzi, Stefania
Cutini, Maristella
Ciabattoni, Francesco
Faggian, Giovanna
Gaio, Paola
Bosa, Luca
Cananzi, Mara
author_sort Bergamo, Chiara
collection PubMed
description BACKGROUND: Liver transplant (LT) recipients, particularly children, have an increased risk of developing de novo food allergies (FAs) after transplantation both compared to all the other transplant groups and to the general population. Little is known about the pathogenesis underlying this phenomenon and comprehensive recommendations or clinical practice guidelines are still lacking, mainly due to the scarcity of high-quality evidence. AIM: We aimed to prepare a systematic review on de novo FA in pediatric LT recipients to assess epidemiology and risk factors, evaluate the correlation to specific food groups, describe clinical manifestations, investigate the rate of tolerance acquisition over time and report available therapeutic strategies. METHODS: We conducted this systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). MEDLINE, Scopus, Web of Science, Wiley online library, Cochrane Library, and ClinicalTrials.gov databases were systematically searched for studies published from January 1980 to September 2021. All the articles were checked independently by two reviewers in two steps. A total of 323 articles were screened, and 40 were included for data extraction. RESULTS AND CONCLUSIONS: We found that de novo FAs develop in the 15% of pediatric LT recipients, especially in the first 2 years after surgery, with higher risk related to younger age at transplantation (especially <2 years of age) and tacrolimus immunosuppression. Subjects are often allergic to multiple foods, and 15% of them suffer from anaphylaxis. The majority of patients do not spontaneously outgrow their symptoms during follow-up. The discontinuation of tacrolimus in favor of cyclosporine or the association of tacrolimus with mycophenolate have been associated with the resolution or the improvement of FA in small retrospective case series and could be considered in case of severe or multiple, difficult to manage FAs. Prospective multicenter studies are needed to confirm these findings, guide the risk-based stratification of pediatric LT recipients, and provide for high-evidence therapeutic strategies for children with de novo FA.
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spelling pubmed-91341202022-05-27 De novo Food Allergy After Pediatric Liver Transplantation: A Systematic Review Bergamo, Chiara Argento, Emily Claire Giampetruzzi, Stefania Cutini, Maristella Ciabattoni, Francesco Faggian, Giovanna Gaio, Paola Bosa, Luca Cananzi, Mara Front Pediatr Pediatrics BACKGROUND: Liver transplant (LT) recipients, particularly children, have an increased risk of developing de novo food allergies (FAs) after transplantation both compared to all the other transplant groups and to the general population. Little is known about the pathogenesis underlying this phenomenon and comprehensive recommendations or clinical practice guidelines are still lacking, mainly due to the scarcity of high-quality evidence. AIM: We aimed to prepare a systematic review on de novo FA in pediatric LT recipients to assess epidemiology and risk factors, evaluate the correlation to specific food groups, describe clinical manifestations, investigate the rate of tolerance acquisition over time and report available therapeutic strategies. METHODS: We conducted this systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). MEDLINE, Scopus, Web of Science, Wiley online library, Cochrane Library, and ClinicalTrials.gov databases were systematically searched for studies published from January 1980 to September 2021. All the articles were checked independently by two reviewers in two steps. A total of 323 articles were screened, and 40 were included for data extraction. RESULTS AND CONCLUSIONS: We found that de novo FAs develop in the 15% of pediatric LT recipients, especially in the first 2 years after surgery, with higher risk related to younger age at transplantation (especially <2 years of age) and tacrolimus immunosuppression. Subjects are often allergic to multiple foods, and 15% of them suffer from anaphylaxis. The majority of patients do not spontaneously outgrow their symptoms during follow-up. The discontinuation of tacrolimus in favor of cyclosporine or the association of tacrolimus with mycophenolate have been associated with the resolution or the improvement of FA in small retrospective case series and could be considered in case of severe or multiple, difficult to manage FAs. Prospective multicenter studies are needed to confirm these findings, guide the risk-based stratification of pediatric LT recipients, and provide for high-evidence therapeutic strategies for children with de novo FA. Frontiers Media S.A. 2022-05-12 /pmc/articles/PMC9134120/ /pubmed/35633971 http://dx.doi.org/10.3389/fped.2022.885942 Text en Copyright © 2022 Bergamo, Argento, Giampetruzzi, Cutini, Ciabattoni, Faggian, Gaio, Bosa and Cananzi. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pediatrics
Bergamo, Chiara
Argento, Emily Claire
Giampetruzzi, Stefania
Cutini, Maristella
Ciabattoni, Francesco
Faggian, Giovanna
Gaio, Paola
Bosa, Luca
Cananzi, Mara
De novo Food Allergy After Pediatric Liver Transplantation: A Systematic Review
title De novo Food Allergy After Pediatric Liver Transplantation: A Systematic Review
title_full De novo Food Allergy After Pediatric Liver Transplantation: A Systematic Review
title_fullStr De novo Food Allergy After Pediatric Liver Transplantation: A Systematic Review
title_full_unstemmed De novo Food Allergy After Pediatric Liver Transplantation: A Systematic Review
title_short De novo Food Allergy After Pediatric Liver Transplantation: A Systematic Review
title_sort de novo food allergy after pediatric liver transplantation: a systematic review
topic Pediatrics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9134120/
https://www.ncbi.nlm.nih.gov/pubmed/35633971
http://dx.doi.org/10.3389/fped.2022.885942
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