Prevention and treatment of hepatic venocclusive disease after high-dose cytoreductive therapy.
Venocclusive disease of the liver (VOD) is one of the most common and serious complications following stem cell transplantation. High-dose chemotherapy or chemoradiotherapy injures the structures of Zone 3 of the liver acinus and produces the clinical syndrome of hepatomegaly or right upper quadrant pain, jaundice, and fluid retention. VOD occurs in up to 54% of stem cell transplant recipients and is fatal in 25-50% of them. While the clinical signs of VOD usually manifest during the first post-transplant week, late presentation can occur. The purpose of this review is to discuss the manifestations and pathophysiology of VOD and the options for prevention and treatment.
Richardson
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P
Bone Marrow Transplant Program, University of Colorado Health Sciences Center, Denver 80262, USA.
Bearman
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SI
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006504:Hepatic Veno-Occlusive Disease / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control; D006801:Humans