title: [Prevention of hepatic veno-occlusive disease by a combination of heparin and prostaglandin E1 in children undergoing hematopoietic stem cell transplantation].
abstract: The effect and safety of combination prophylaxis for hepatic veno-occlusive disease (VOD) following stem cell transplantation (SCT) was retrospectively evaluated in a total of 53 children who survived until day 30. Prophylaxis was started on the day before conditioning, and heparin (10 unit/kg/hr) alone was used in 6 patients, PGE1 (5 ng/kg/min) plus heparin plus PTX (200 mg/day) in 17 patients, lipo-PGE1 (0.5 ng/kg/min) plus heparin plus PTX in 7 patients, and lipo-PGE1 plus heparin in 23 patients. Diagnosis of VOD was made based on McDonald's criteria in 5 cases (9.4%), but not on Jones' criteria. No statistically significant difference was observed in the incidence of VOD among each prophylaxis group. The degree of VOD was mild in all of 5 cases, and all recovered with continuation of the prophylactic procedure. Each prophylactic procedure was performed without any significant adverse effect except for seizure induced by lipo-PGE1 in one patient with Lennox syndrome. Since both the incidence and fatality rate of VOD in children undergoing SCT are approximately 20% according to most of the previous reports, the present study suggests the effectiveness of combination prophylaxis.
authors.affiliation: Department of Pediatrics, Faculty of Medicine, University of Yamanashi.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Inukai
authors.forename: Kanji
authors.initials: K
authors.lastname: Sugita
authors.forename: Kumiko
authors.initials: K
authors.lastname: Goi
authors.forename: Koshi
authors.initials: K
authors.lastname: Akahane
authors.forename: Kinuko
authors.initials: K
authors.lastname: Hirose
authors.forename: Atsushi
authors.initials: A
authors.lastname: Nemoto
authors.forename: Kazuya
authors.initials: K
authors.lastname: Takahashi
authors.forename: Hiroki
authors.initials: H
authors.lastname: Sato
authors.forename: Kanako
authors.initials: K
authors.lastname: Uno
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Furuichi
authors.forename: Makoto
authors.initials: M
authors.lastname: Nakamura
authors.forename: Naohiko
authors.initials: N
authors.lastname: Miyamoto
authors.forename: Naoko
authors.initials: N
authors.lastname: Yamakawa
authors.forename: Kyoko
authors.initials: K
authors.lastname: Shiraishi
authors.forename: Satoru
authors.initials: S
authors.lastname: Kojika
authors.forename: Toru
authors.initials: T
authors.lastname: Tezuka
authors.forename: Kiyomu
authors.initials: K
authors.lastname: Iijima
authors.forename: Shinpei
authors.initials: S
authors.lastname: Nakazawa
mesh_terms: D000293:Adolescent; D000527:Alprostadil / Q000008:administration & dosage*; D002648:Child; D004359:Drug Therapy, Combination; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006493:Heparin / Q000008:administration & dosage*; D006504:Hepatic Veno-Occlusive Disease / Q000517:prevention & control*; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000517:prevention & control; D012189:Retrospective Studies
chemical_list: D006493:Heparin; D000527:Alprostadil