Transfusion‐associated graft‐versus‐host disease: do transfusions from second‐degree relatives pose a greater risk than those from first‐ degree relatives?

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Abstract
When a patient receives blood from a closely related donor, there is the potential for transfusion‐associated graft‐versus‐host disease (TA‐ GVHD). With a mathematical model, the potential risk of TA‐GVHD was derived for six classes of related donors. This risk was considered to be present when an HLA‐heterozygous patient received blood from a donor who was homozygous for one of the patient's haplotypes. Calculations showed that second‐degree related donors present a greater risk of TA‐ GVHD than some (siblings) but not all (parents, children) first‐degree related donors. Moreover, there is, in general, no sharp cutoff of risk among the various classes of donors. These results should be considered in the determination of a policy for the irradiation of directed‐donor units.