Blood Donor Diet May Be Linked to Transfusion Reactions in Some Pediatric Patients

A blood donor’s pre-donation diet could potentially be linked to allergic transfusion reactions (ATRs) in pediatric transfusion recipients with food allergies, according to a new study from Japanese researchers. The findings were published in Allergy.  

While ATRs are commonly attributed to immunoglobulin E (IgE)-mediated type 1 allergy, the specific allergens responsible are not always known. In a previous study, investigators from Shinshu University Hospital and Nagano Children's Hospital found that pediatric patients with food allergies may be more prone to developing ATRs. Building upon those findings, the research team sought to better understand the link between donor diet and ATR development.

Between May 2022 and December 2023, investigators collected blood samples from more than 100 pediatric patients who received a blood transfusion and also had previously diagnosed food allergies to eggs, wheat or milk. They also collected blood from two healthy donors before and after significant consumption of these allergenic foods, with serum extraction for analysis. Researchers conducted basophil activation tests (BATs), a functional assay that measures the degree of degranulation following stimulation with an allergen, by exposing the blood samples to the corresponding sera.

Among patients with egg allergies, BAT levels were significantly higher when the blood was exposed to the serum of donors who had ingested eggs. In addition, serum obtained from donor samples collected four hours after egg ingestion resulted in markedly higher BAT levels than those collected two hours after egg ingestion. Results for milk and wheat were more varied, with BAT levels only being elevated after exposure to the serum of one of the two donors.

According to investigators, the findings suggest that ATRs could be triggered by the food donors consume before a blood donation. While further analyses and experiments are necessary to confirm these findings, they believe this represents a first step towards understanding the mechanisms underlying ATRs.

“In the future, it could be possible to predict in advance who is likely to suffer from an ATR,” said co-lead investigator Ryu Yanagisawa, MD, PhD. “Given enough time, preventive measures and countermeasures to ATRs could be developed, leading to safer blood transfusions.”