Perioperative implications of patients with alpha gal allergies

J Clin Anesth. 2023 Jun:86:111056. doi: 10.1016/j.jclinane.2023.111056. Epub 2023 Jan 20.

Abstract

Alpha Gal Syndrome (AGS) is an emerging immune response to mammalian products (MP) containing the oligosaccharide galactose-α-1,3 galactose (α-Gal) which includes meats and inactive ingredients in certain medications. This becomes clinically important in the perioperative realm as MPs are commonly found in the operating room, and pre- and post-operative settings, and can trigger responses as severe as anaphylaxis. In this review, authors discuss the epidemiology, diagnosis and treatment of AGS reactions. Additionally, strategies are explored in order to screen and prevent exposure to MP with a multidisciplinary approach. While this emerging allergy is still not fully understood, it is of paramount importance that all anesthesia providers recognize the implications of MP exposure in AGS patients and ultimately prevent harm in this highly vulnerable population.

Keywords: Alpha gal syndrome; Anesthesia; Heparin; Mammalian products; Red meat allergy; Surgery.

Publication types

  • Review

MeSH terms

  • Anaphylaxis* / diagnosis
  • Anaphylaxis* / epidemiology
  • Anaphylaxis* / etiology
  • Animals
  • Food Hypersensitivity* / epidemiology
  • Galactose
  • Humans
  • Mammals
  • Meat / adverse effects

Substances

  • Galactose

Supplementary concepts

  • red meat allergy