Q:

11/13/2012
62yr old male renal transplant on cellcept, prograf and 10mg prednisone for 10 yrs. Skin test pos, for pollen mold mite. He is miserable despite otc antihistamines plus others he wants allergy desensitization I think it should be ok? Any data to predict benefit/risk. Thanks.

A:

Thank you for your inquiry.

In brief, I could find no definite contraindication to allergen immunotherapy in a patient who has had a solid organ transplant and is taking immunomodulatory, immunosuppressive drugs. The question is whether or not there will be an adequate response to immunotherapy in this setting. We do not have a definitive answer to that question.

So, although there is no specific contraindication to immunotherapy in this setting, and I have personally employed immunotherapy in such situations without adverse response, there is a question as to the response to such treatment.

We have dealt with this issue on several occasions on our website, and for more details you might find these entries helpful. They include the following:

Posted 11/12/2012 - Potential effect of allergen immunotherapy on solid organ transplants

Posted 6/28/2012 - Contraindications to immunotherapy

Posted 1/13/2012 - The safety of immunotherapy in a patient on 6-Mercaptopurine to treat ulcerative colitis

Thank you again for your inquiry and we hope this response is helpful to you.

Sincerely,
Phil Lieberman, M.D.

AAAAI - American Academy of Allergy Asthma & Immunology