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183 ETHNIC DIVERSITY AND ALLERGY IN TRANSPLANT PATIENTS KJ Khan, MA Levstik Allergic reactions are immune mediated disorders that are important to identify, as transplantation requires the use of medications including immune mediators exposing patients to potential adverse outcomes. Allergy and atopy prevalence is variable among ethnic groups as studied mostly in the United States. But little is known about the relationship between allergy prevalence and a country's ethnic diversity. Ethnically homogeneous countries may have gene pool adaptation over time and lower allergy prevalence as a result.
Division of Gastroenterology, London Health Sciences Centre, London, Ontario
SETTING: In 2005, London, Ontario, hosted over 800 athletes from around the world in the 15th World Transplant Games. This provided us with the unique opportunity to explore the relationship between ethnic diversity and allergy in a patient population with extensive medical care, including immune modulators; transplant patients.
METHODS: Our a priori hypothesis was that countries with greater ethnic diversity would have higher allergy rates. The medical records of 854 athletes participating in the World Transplant Games were analyzed and allergy data extracted from 847/854 (99.2%). We used the Central Intelligence Agency's World Factbook to determine the ethnic composition of the countries of origin. Allergy rates were compared to the homogeneity of the home country (highest percentage single ethnic group & number of ethnic groups to reach 85% of the total population).
RESULTS: There were 847 athletes from 45 countries in 6 continents. The allergy rates of patients from countries with a single ethnicity of 90% or more of their population were only 7.8% compared to 25.4% from other countries. Moreover, on a scatter plot of allergy rates and ethnicity, a clear trend suggests that more ethnically diverse populations have higher allergy rates. This trend was consistent when ranking countries by the highest single ethnic group and by number of ethnic groups to reach 85% of the total population.
CONCLUSIONS: This study suggests that allergy rates of transplant patients from more homogenous ethnic populations are lower. These results support our a priori hypothesis. More ethnically diverse countries have higher migrated populations that develop allergies secondary to new antigenic exposure whereas the immune systems of established populations may adapt over time and have fewer allergies. These conclusions put the onus on transplant physicians in countries with newer immigrant populations (North America, Australia) to be more vigilant in screening donors and recipients for allergies.