A Lung Transplant Came With An Allergy

A 68-year-old woman ate a peanut butter and jelly sandwich the day before she was due to go home from the hospital. She'd eaten peanut butter her entire life without incident. Within minutes, she couldn't breathe.

She had never had a peanut allergy. But her donor did.

The woman had received a single-lung transplant to treat her emphysema, getting a new left lung from a 22-year-old male donor. Recovery was going well until the day before discharge, when she felt chest tightness and severe difficulty breathing. Doctors couldn't find a clear explanation until she mentioned the symptoms had started right after the sandwich. That timing made a food allergy the working theory, even though she had none of the typical signs: no rash, no stomachache.

Here's the part that should make you set down whatever you're eating. It's rare for lung transplant recipients to acquire a food allergy from a donor organ, but the mechanism, when it happens, is what gets you: the transplanted lung carries the donor's immune cells inside it, and those cells bring their immunological opinions along. The new lung remembered what it was afraid of. The new host had no idea.

Only about four or five case reports exist of organ recipients acquiring peanut allergies with anaphylaxis following a lung transplant. What doctors still don't fully understand is why it happens in some cases and not others, or how long the transferred allergy might last.

The woman survived. She now carries an EpiPen. Her lung is still not okay with peanuts.

Read the full story at Live Science, December 31, 2018

Hot Take: New lung, but no more Reese's. That still seems like a fair trade.