Transfusion-Associated Graft-versus-Host Disease

To the Editor: In the review article by Anderson and Weinstein (Aug. 2 issue), 1 sharing one HLA haplotype is postulated as a risk factor for the development of transfusion-associated graft-versus-host disease. However, no mention is made of the occurrence of graft-versus-host disease in patients who receive donor-specific blood transfusions before transplantation from living related kidney donors. Since donor-specific transfusions were first recommended in 1980, 2 hundreds of would-be kidney recipients have received transfusions of whole blood or derivatives from relatives who share one HLA haplotype. 2 The underlying chronic renal failure and (since 1982) the frequent use of azathioprine to avoid sensitizaron . . .