In a remarkable display of international medical cooperation, eight kidney transplants have been performed across Israel and Cyprus as part of a pioneering cross-border organ exchange program. The intricate operation, involving multiple hospitals and a meticulously coordinated logistics effort, was made possible by two altruistic donors who approached the National Transplant Center, initiating a "transplant chain."

The joint operation, conducted on Monday, saw five procedures taking place in Israel and three in Cyprus. The National Transplant Center matched the pairs using specialized computer software, drawing from an international database containing incompatible family member pairs.

Starting at 5:00 a.m., kidneys harvested at Hadassah and Soroka hospitals were transported by ambulance to the airport and flown to Cyprus. Concurrently, another kidney from Hadassah was transferred to Soroka, while one from Beilinson was sent to Hadassah. At 2:00 p.m., two kidneys arrived from Cyprus, destined for Beilinson and Hadassah. By 6:00 p.m., all transplants were completed in both countries, with recipients in good condition and new kidneys functioning.

In Israel, three transplants occurred at Hadassah, one at Beilinson, and one at Soroka, with an additional Hadassah transplant performed a day earlier. In total, Israel saw 10 surgeries: five kidney removals and five transplants.

Professor Shlomo Mor Yosef, chairman of the Steering Committee, said, "I commend the cooperation between Israel and Cyprus. These exchanges provide solutions for patients with antibodies. I urge every family with a patient needing a kidney transplant to join the exchange database if no match is found among them."

Dr. Tamar Ashkenazi commented, "This marks our first two-way kidney exchange with Cyprus. Their single transplant center in Nicosia performed six surgeries in one day, supported by a surgeon from England. I'd like to thank Ms. Rona Simon, who manages our exchange database, facilitating over 60 successful cross-transplants annually. Israel maintains similar programs with the Czech Republic, Austria, and the United Arab Emirates."

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A significant position paper was published today (Sunday) by the Israeli Association of Allergy and Clinical Immunology - warning that temporary feeding with cow's milk-based infant formula (IMF) in the first few days of life may increase the risk of developing a milk allergy.

The position paper is based on several  medical studies published in recent years, and the recommendations of the European Academy of Allergy and Clinical Immunology (EAACI). the paper is directed at medical teams in neonatal units, new mothers, expectant parents, the medical community, and the general public, focusing on the feeding of newborns in the first days after birth.

Cow's milk protein allergy (CMPA) is one of the most common food allergies in infancy. Over the past few decades, the incidence of food allergies in general, and CMPA specifically, has increased. The data is clear: the prevalence of CMPA among young children in Israel at the beginning of the 2000s was between 0.3% to 0.5%, but it is now estimated to be between 0.85% and 1% - more than a twofold increase, in just two decades.

While CMPA often resolves in early childhood (in 60%-70% of cases), its health implications are significant, even in cases that resolve early, and especially for those who remain allergic into adolescence and adulthood. CMPA can lead to nutritional deficiencies during growth and development, which may impact height potential in adulthood and reduce bone density. Additionally, CMPA is responsible for the majority of life-threatening allergic reactions in Israel. Given these health implications, the risk of severe allergic reactions, and the impact on quality of life, primary prevention of CMPA is critically important.

The World Health Organization (WHO) recommends that infants be exclusively breastfed from the first hour of life and continue breastfeeding exclusively (without additional foods or fluids, including water) for at least six months. However, a recent study conducted in Israel found that while the majority of new mothers (96%) believed their infants were exclusively breastfed from birth, the majority of infants (55%) actually received additional cow's milk-based formula during this period - while in the hospital.

Furthermore, several studies published in recent years have demonstrated that infants who were fed cow's milk-based formula in the first days of life, even in small amounts, and were then exclusively breastfed, developed milk allergies at a higher rate than infants who were exclusively breastfed from birth or who were consistently fed a combination of breastfeeding and formula.

The 2021 guidelines from the European Academy of Allergy and Clinical Immunology, along with accompanying clarifications, suggest avoiding the temporary addition of cow's milk-based formula in the first week after birth to prevent the development of milk allergies. Recent studies in Israel have confirmed these findings and support the recommendations of the European Academy. The accumulated conclusions indicate that temporary feeding of infants with cow's milk-based formula in the first days of life, even in small amounts, followed by exclusive breastfeeding, may increase the risk of developing a milk allergy.

In light of this, to reduce the risk of infants developing CMPA, the Israeli Association of Allergy and Clinical Immunology recommends:

1. Mothers who intend to exclusively breastfeed should avoid giving their infants cow's milk-based formula in the first days of life.
2. If the infant received small amounts of cow's milk-based formula in the first days of life, regular supplementation with the formula a few times a week, in parallel with breastfeeding, may reduce the risk of developing a milk allergy.

The position paper is endorsed by members of the Israeli Association of Allergy and Clinical Immunology: Chairman, Prof. Arnon Elitzur (Shamir Medical Center - Assaf Harofeh), former Chairman Prof. Alon Hershko (Hadassah Medical Center), Secretary of the Association Prof. Yuval Tal (Hadassah Medical Center), Prof. Ilan Dalal (Wolfson Medical Center), Prof. Avraham Beigelman (Schneider Children's Medical Center), Dr. Idit Lahover Roth (Meir Medical Center), Dr. Ramit Maoz-Segal (Sheba Medical Center), and Prof. Aharon Kesel (Bnei Zion Medical Center).

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