[Blood donation by relatives in pediatrics].

Directed blood donations from family members are frequently desired for pediatric patients. A reduced risk for transfusion-transmitted diseases could not be proved. There are indications that recommendation of directed blood donation could oblige members of risk groups for HIV or hepatitis infection to donate blood since their voluntariness is not guaranteed and the possibility of self-exclusion is omitted. In some instances it may be necessary to perform directed blood donations from relatives because of immunological or medical principles, e.g. transfusion of maternal platelets in neonatal alloimmune thrombocytopenia. In contrast, directed blood donations should not be realized for most hematologic-oncologic patients because they bear the risk of immunisation against alloantigens of the donor and can thus prevent a later bone marrow transplantation from relatives. Inspite of reservations against directed blood donations for individual cases the pediatrician and the transfusion medicine service will have to decide on blood donations from relatives. In any case the blood products should be irradiated with 30 Gy to avoid a transfusion-related graft-versus-host-reaction.