[Veno-occlusive disease--an important complication in hematopoietic cells transplantation].
Hemopoietic stem cell transplantation is frequently used in clinical practice. However, many severe complications limit its usage. One of the most important is veno-occlusive disease of the liver (VOD). The key pathophysiologic event is a damage to epithelium during chemotherapy. Gradual development of intrahepatic portal hypertension leads to clinical manifestations (jaundice, liver enlargement, ascites). Many risk factors has been identified (pre-transplant liver disturbance, chemotherapy and conditioning, drugs). The diagnosis is based on clinical criteria and exclusion of other diseases. Laboratory, haemodynamic, ultrasound studies and histopathology are very important in diagnosis. In pharmacological prophylaxis heparin is widely used. Therapy requires strict fluid and electrolyte balance. Some patients can benefit from transjugular intrahepatic portosystemic shunt (TIPS) or liver transplantation. Defibrotide gives more hope for patients but further investigations are needed.
Skotnicki
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Klinika Hematologii Collegium Medicum Uniwersytet Jagielloński, 31-501 Kraków ul. Kopernika 17.
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D000925:Anticoagulants / Q000627:therapeutic use; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006493:Heparin / Q000627:therapeutic use; D006504:Hepatic Veno-Occlusive Disease / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D016031:Liver Transplantation; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011089:Polydeoxyribonucleotides / Q000627:therapeutic use; D019168:Portasystemic Shunt, Transjugular Intrahepatic; D012307:Risk Factors; D014882:Water-Electrolyte Balance
D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors; D011089:Polydeoxyribonucleotides; C036901:defibrotide; D006493:Heparin