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Risk for platelet\u2010associated ATRs can result from recipient\u2010 or donor\u2010specific factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design and Methods<\/jats:title><jats:p>We report a rare case in which an individual platelet donor caused repeated ATRs in multiple recipients. This observation led us to conduct a retrospective study at a pediatric hematology\u2010oncology center to identify donor\u2010 and recipient\u2010associated risk factors for ATRs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Single\u2010donor platelets from an individual donor precipitated ATRs in 78.6% (n = 11\/14) of recipients and 66.7% (n = 12\/18) of platelet transfusions. We found in a cohort of pediatric hematology\u2010oncology patients that 12.6% of recipients and 1.0% of platelet transfusions were associated with ATRs. Recipients who were aged 4 to 18\u2009years, male, and those with central nervous system or solid tumors and with a history of ATRs to platelets were more likely to experience ATRs. Donor\u2010associated risk factors were not identified, and we did not implicate additional donors in our single\u2010center cohort with a frequency of ATRs comparable to the index donor. Based on our findings, we developed a novel statistical model to identify recipients and donors prone to experiencing or mediating ATRs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Both donors and recipients contribute to ATRs. Identification of high\u2010risk donors and recipients for further scrutiny and potential interventions can improve the safety of platelet transfusions.<\/jats:p><\/jats:sec>","DOI":"10.1111\/trf.16221","type":"journal-article","created":{"date-parts":[[2020,12,14]],"date-time":"2020-12-14T10:14:39Z","timestamp":1607940879000},"page":"744-753","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Contribution of donor\u2010 and recipient\u2010associated factors to allergic transfusion reactions to platelets"],"prefix":"10.1111","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7254-7564","authenticated-orcid":false,"given":"Yan","family":"Zheng","sequence":"first","affiliation":[{"name":"Department of Pathology St. Jude Children\u02bcs Research Hospital  Memphis Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deqing","family":"Pei","sequence":"additional","affiliation":[{"name":"Department of Biostatistics St. Jude Children\u02bcs Research Hospital  Memphis Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lori","family":"Sweat","sequence":"additional","affiliation":[{"name":"Department of Pathology St. Jude Children\u02bcs Research Hospital  Memphis Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Missy","family":"Ryan","sequence":"additional","affiliation":[{"name":"Department of Pathology St. Jude Children\u02bcs Research Hospital  Memphis Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark A.","family":"Mestemacher","sequence":"additional","affiliation":[{"name":"Department of Pathology St. Jude Children\u02bcs Research Hospital  Memphis Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Gann","sequence":"additional","affiliation":[{"name":"Department of Pathology St. Jude Children\u02bcs Research Hospital  Memphis Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheng","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Biostatistics St. Jude Children\u02bcs Research Hospital  Memphis Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Terrence L.","family":"Geiger","sequence":"additional","affiliation":[{"name":"Department of Pathology St. Jude Children\u02bcs Research Hospital  Memphis Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,12,13]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tmrv.2006.09.001"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.12827"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.12150"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1537-2995.2012.03892.x"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2016.02.015"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2017.01193"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1537-2995.2011.03310.x"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1537-2995.2006.00995.x"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2008.07022.x"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.12520"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.12791"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.14359"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.2.4363.236"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1423-0410.1995.tb02598.x"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1537-2995.2011.03160.x"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/vox.12373"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1979.03290310035011"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1537-2995.2005.04320.x"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.167.8.853"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1537-2995.2011.03126.x"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc1101692"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1398-9995.2005.00896.x"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1537-2995.2010.03009.x"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1537-2995.2010.02897.x"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1537-2995.2011.03476.x"},{"key":"e_1_2_9_27_1","unstructured":"Novartis Pharmaceutical Corp.https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2017\/021283s50lbl.pdf. 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