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Vol. 46. Issue 5.
Pages 447-453 (September - October 2018)
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Vol. 46. Issue 5.
Pages 447-453 (September - October 2018)
Original Article
DOI: 10.1016/j.aller.2017.09.030
Increase of natural killer cells in children with liver transplantation-acquired food allergy
F. Moria, C. Angeluccia, A. Cianferonib, S. Barnia,
Corresponding author

Corresponding author.
, G. Indolfic, A. Casinid, G. Mangoned, M. Materassie, N. Puccia, C. Azzaric, E. Novembrea
a Allergy Unit, Department of Paediatrics, Anna Meyer Children's University Hospital, Florence, Italy
b Allergy and Immunology Division, Children's Hospital of Philadelphia, PA, USA
c Pediatric and Liver Unit, Meyer Children's University Hospital of Florence, Florence, Italy
d Division of Immunology, Section of Paediatrics, Department of Health Sciences, Anna Meyer Children's University Hospital, Florence, Italy
e Pediatric Nephrology Unit, Meyer Children's University Hospital, Florence, Italy
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Figures (1)
Tables (3)
Table 1. Characteristics of liver- and kidney-transplant patients.
Table 2. Clinical and allergic features in patients with post-liver transplantation food allergy.
Table 3. Serum cytokines in liver-transplant patients with and without TAFA and kidney-transplant patients and controls; total IgE in liver- and kidney-transplant patients and in allergic and non-allergic liver-transplant patients.
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Transplantation-acquired food allergies (TAFA) are frequently reported and considered to be caused by immunosuppressive therapy.

The aim of this study was to investigate the allergic and immunologic responses in children who had liver or kidney transplantations.


Twelve children receiving liver transplantations and 10 children receiving kidney transplantations were investigated. All children underwent the allergy work-up and in most of them, lymphocyte screening and serum cytokine measurements were also performed.


TAFA were found in 7/12 (58%) children with liver transplantations and in none of the 10 children with kidney transplantations. The mean age at transplantation was significantly lower in children who underwent liver transplantations (p<0.001). The immunosuppressive therapy administered to children with liver transplantation was tacrolimus in 11 patients and cyclosporine in one patient, while all 10 children with kidney transplantation received tacrolimus plus mycophenolate. The most common antigenic food was egg. The natural killer (NK) cell numbers were significantly higher in liver-transplant children than in kidney-transplant children. No significant differences were found in the serum cytokine levels.


This study confirms that liver-transplant children treated with tacrolimus alone have a higher risk of developing TAFA than kidney-transplant children treated with tacrolimus plus mycophenolate. NK cells might be involved in this difference.

Immunosuppressive drugs
Food allergy
Kidney transplantation
Liver transplantation


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