It was just a Sandwich

The new lung is failing out of nowhere. Only two weeks after the Transplantation of the organ, which has survived the Elderly woman well, she wrestles suddenly to the air. The oxygen saturation in your blood drops rapidly, the Doctors at the hospital of the University of California-San Diego need to act quickly.

Press the 68-Year-old to a respiratory mask on the mouth and connect to a machine that supports your lungs at work. But the problems remain. The doctors have no other choice, slide a tube into the trachea and to ventilate them artificially. It had all started so well.

Two weeks earlier, the woman had been operated on in the clinic. A genetic disorder had destroyed her left lung. The Doctors transplanted the lung of a 22-year-old organ donor who died of a drug Overdose. The surgery was successful.

A day after the surgery, the Doctors were able to pull the breathing tube, shortly thereafter, the lungs supplied the woman’s body alone again with oxygen. The Doctors prepare the patient on the dismissal, as it is a sudden emergency. What happened?

X-Ray, Ultrasonic, Lung Mirroring

Yet while the physician to connect the woman to the breathing machine, start the track search. Helpers bring an x-ray device to the bed of the patient, as the Doctors report to Mazen Odis in the journal “transplantation Proceedings”. The recordings can expose inflammation, harmful fluid or air accumulation, on the images of the woman, however, nothing appears.

The next suspicion is the blood vessels. Sudden lung failure often results from blood clots that remain in the tight braid of the pulmonary vessels hang. There, they prevent the circulation of the blood, the tissue dies. On CT scans, the physicians recognize, however, only a tiny blocked. Also on images from a camera, push the Doctors in the lung of the woman, shows healthy tissue. Notes on a foreign body, which could hinder breathing, lack.

The woman seems to be recovering. But before the Doctors are afraid to pull the breathing tube again, you want to exclude a last cause. You examine the patient’s heart via ultrasound. Pumps especially the left Ventricle is too weak, it may happen that the blood accumulates in the lungs and fluid in the tissue pushes. The woman’s heart beats strong.

Fateful Sandwich

Although the Doctors still don’t know what the Problem is. Organic causes can be ruled out to a large extent. 18 hours after the respiratory failure, pull the ventilation hose from the lungs, the unsuccessful attempt. The patient begins to breathe independently again – and can answer this questions for the Doctors.

Until shortly before the respiratory failure, she had no symptoms, telling the patient. Then she adds the crucial note: Before the problems began, she had eaten a Sandwich with jam and peanut butter. Directly after that, it felt, as you would tie up someone to the chest.

The woman had never even a peanut Allergy. The Doctors contact the transplant authority – and indeed The donor was allergic to peanuts. In his blood anti-body swim against a specific peanut protein.

In the blood of the patient these antibodies were missing. This does not mean, however, that she has not developed the Allergy. Instead, the lack of antibodies with drugs, declare, taking all patients after Transplantation and to suppress the immune system.

More transplanted allergies

Several cases are already known in which an organ donor allergies transferred. 2008, for example, physicians reported a 42-Year-old, who received both lungs from a donor who had died after eating peanuts in an allergic shock. Seven months later, the woman at the Meeting, a Pro-organ donation group ate a peanut-Cookie – and suffered an allergic shock. She survived thanks to the quick reaction of their environment.

Be transferred to the allergies probably about antibody in the tissue of the donor. Many of the cases would be overlooked, because the phenomenon is so rare and adults can also develop for no apparent reason all of a sudden allergies, suggest the authors of the current case report. You advise to test after transplantation by default, the allergies of the donor.

Your patient, the physicians at the time of dismissal, peanuts, and all nuts recommend to avoid for the time being. In addition, they prescribe syringe you have an Emergency. In a study three months later, the Doctors find no peanut antibodies in the blood of the patient. In the case of a sensitive skin test this, however, react to peanuts, almonds, Cashews, coconuts and hazelnuts.

The next Time you want to examine the 68-Year-old, a year after the transplant on allergies, write to the Doctors. Other patients with the problems developed in this period.

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