title: Diagnosis of hepatic veno-occlusive disease by plasminogen activator inhibitor-1 plasma antigen levels: a prospective analysis in 350 allogeneic hematopoietic stem cell recipients.
abstract: BACKGROUND
  Veno-occlusive disease (VOD) is one of the most serious complications following allogeneic hematopoietic stem cell transplantation (HSCT) and is associated with a high mortality. We conducted a large trial in order to investigate the value of plasminogen activator inhibitor-1 (PAI-1) plasma antigen levels in VOD patients as PAI-1 has been described as a possible diagnostic marker of VOD.
  
  
  METHODS
  In all, 350 stem cell recipients were included in our study. PAI-1 levels were analyzed prior to conditioning therapy and then weekly until eight weeks after HSCT. Transplantation-related complications (TRC) including VOD, microangiopathic hemolytic anemia (MAHA), and graft-versus-host disease (GVHD) were recorded weekly throughout the study.
  
  
  RESULTS
  Maximum PAI-1 antigen levels were increased in all patients with VOD (n=15; mean 248 ng/ml; 95% CI 183-314 ng/ml). Maximum PAI-1 levels above 120 ng/ml showed a sensitivity of 100% and a specificity of 30.6% for VOD after HSCT.
  
  
  CONCLUSIONS
  Our study underlines that maximum PAI-1 plasma antigen levels not exceeding 120 ng/ml have a strong negative predictive value in the diagnosis of VOD and thus represent a helpful non-invasive tool for exclusion of VOD after HSCT.
authors.affiliation: Abteilung fuer Haematologie und Internistische Onkologie, Klinikum der, Universitaet Regensburg, Regensburg, Germany. Markus.Pihuscht-online.de
authors.forename: Markus
authors.initials: M
authors.lastname: Pihusch
authors.forename: Holger
authors.initials: H
authors.lastname: Wegner
authors.forename: Peter
authors.initials: P
authors.lastname: Goehring
authors.forename: Christoph
authors.initials: C
authors.lastname: Salat
authors.forename: Verena
authors.initials: V
authors.lastname: Pihusch
authors.forename: Erhard
authors.initials: E
authors.lastname: Hiller
authors.forename: Reinhard
authors.initials: R
authors.lastname: Andreesen
authors.forename: Hans-Jochem
authors.initials: HJ
authors.lastname: Kolb
authors.forename: Ernst
authors.initials: E
authors.lastname: Holler
authors.forename: Rudolf
authors.initials: R
authors.lastname: Pihusch
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000743:Anemia, Hemolytic / Q000097:blood; D005260:Female; D006086:Graft vs Host Disease / Q000209:etiology; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006504:Hepatic Veno-Occlusive Disease / Q000175:diagnosis* / Q000503:physiopathology; D006801:Humans; D007239:Infections / Q000097:blood; D008297:Male; D008875:Middle Aged; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood*; D011446:Prospective Studies; D019172:Transplantation Conditioning / Q000009:adverse effects
chemical_list: D017395:Plasminogen Activator Inhibitor 1