title: Is the sinusoidal obstructive syndrome post-liver transplantation a pathologic entity with a multifactorial etiology?
abstract: The sinusoidal obstructive syndrome is a complication typically associated with hematopoietic stem cell transplantation. This syndrome, more commonly known as veno-occlusive disease, has also been described after liver transplantation. It can have a life-threatening course. Herein, we describe the hepatic graft loss secondary to the development of a sinusoidal obstructive syndrome after a severe acute cellular rejection and toxic levels of once daily modified released tacrolimus (TAC). We discuss the role of the endotheliitis of acute rejection and toxic metabolites of some immunosuppressants such as azathioprine and TAC. Based on the current scientific evidence, we contemplate the possibility that the etiology of sinusoidal obstruction syndrome post-liver transplantation is multifactorial.
authors.forename: Luis Miguel
authors.initials: LM
authors.lastname: Marín-Gómez
authors.forename: José María
authors.initials: JM
authors.lastname: Álamo-Martínez
authors.forename: Gonzalo
authors.initials: G
authors.lastname: Suárez-Artacho
authors.forename: José
authors.initials: J
authors.lastname: Ramírez-Santos
authors.forename: Carmen
authors.initials: C
authors.lastname: Bernal-Bellido
authors.forename: Lydia
authors.initials: L
authors.lastname: Barrera-Pulido
authors.forename: Juan
authors.initials: J
authors.lastname: Serrano-Díaz-Canedo
authors.forename: Francisco Javier
authors.initials: FJ
authors.lastname: Padillo-Ruiz
authors.forename: Miguel Ángel
authors.initials: MÁ
authors.lastname: Gómez-Bravo
mesh_terms: D000328:Adult; D004359:Drug Therapy, Combination; D005260:Female; D006084:Graft Rejection / Q000517:prevention & control; D006504:Hepatic Veno-Occlusive Disease / Q000209:etiology* / Q000473:pathology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016031:Liver Transplantation; D011183:Postoperative Complications / Q000209:etiology* / Q000473:pathology
chemical_list: D007166:Immunosuppressive Agents