title: Veno-occlusive disease/sinusoidal obstruction syndrome after haematopoietic stem cell transplantation: Middle East/North Africa regional consensus on prevention, diagnosis and management.
abstract: Veno-occlusive disease/sinusoidal obstruction syndrome (VOD/SOS) of the liver is a serious, early complication of haematopoietic stem cell transplantation (HSCT), severe and very severe forms of which are associated with a high mortality rate. A wide variety of patient, disease and treatment-related risk factors for VOD/SOS have been identified. Several bodies have published recommendations for the diagnosis, prevention and management of VOD/SOS following HSCT. A group of regional experts have developed a consensus statement on the diagnosis, prevention and management of VOD/SOS in the Middle East and North Africa region to help in the management of HSCT patients in the region. Risk factors of particular relevance in the region include iron overload in thalassaemia patients, some hereditary metabolic disorders due to consanguinity and infection with hepatitis virus B or C. Recommendations include diagnosis of VOD/SOS based on established clinical criteria, prophylaxis with defibrotide and/or ursodeoxycholic acid in patients at increased risk of VOD/SOS, and treatment with defibrotide for patients with severe/very severe VOD/SOS (and, if clinically indicated, in those with moderate or rapidly progressing VOD/SOS, as per the new European Society for Blood and Marrow Transplantation classification).
authors.affiliation: Pediatric Hematology/Oncology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
authors.forename: A H
authors.initials: AH
authors.lastname: Al Jefri
authors.affiliation: Bone Marrow Transplant Program, King Hussein Cancer Center, Amman, Jordan.
authors.forename: H
authors.initials: H
authors.lastname: Abujazar
authors.affiliation: Pediatric Hematology/Oncology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.|College of Medicine, Alfaisal University, Riyadh, Saudi Arabia.
authors.forename: A
authors.initials: A
authors.lastname: Al-Ahmari
authors.affiliation: Pediatric Hematology/Oncology & HSCT, Department of Child Health, Sultan Qaboos University Hospital, Muscat, Oman.
authors.forename: A
authors.initials: A
authors.lastname: Al Rawas
authors.affiliation: Leukemia, Bone Marrow Transplant Unit, King Abdulaziz Medical City-WR, National Guard Health Affairs, Jeddah, Saudi Arabia.
authors.forename: Z
authors.initials: Z
authors.lastname: Al Zahrani
authors.affiliation: Oncology Department, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
authors.forename: A
authors.initials: A
authors.lastname: Alhejazi
authors.affiliation: Department of Hematology and Cell Therapy, 1st November University Hospital, Ahmed Benbella University of Oran, Oran, Algeria.
authors.forename: M A
authors.initials: MA
authors.lastname: Bekadja
authors.affiliation: Department of Medicine, Makassed University Hospital, Beirut, Lebanon.
authors.forename: A
authors.initials: A
authors.lastname: Ibrahim
authors.affiliation: Clinical Hematology, Faculty of Medicine and Pharmacy, CHU Mohammed VI, Marrakech, Morocco.
authors.forename: M
authors.initials: M
authors.lastname: Lahoucine
authors.affiliation: Bone Marrow Transplant Unit, Kuwait Cancer Control Center, Shuwaikh, Kuwait.
authors.forename: S
authors.initials: S
authors.lastname: Ousia
authors.affiliation: Department of Internal Medicine, American University of Beirut, Beirut, Lebanon.
authors.forename: A
authors.initials: A
authors.lastname: Bazarbachi
mesh_terms: D000352:Africa, Northern; D019468:Disease Management; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006504:Hepatic Veno-Occlusive Disease / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control / Q000628:therapy; D006801:Humans; D008877:Middle East; D011089:Polydeoxyribonucleotides / Q000627:therapeutic use; D012307:Risk Factors; D014580:Ursodeoxycholic Acid / Q000627:therapeutic use
chemical_list: D011089:Polydeoxyribonucleotides; C036901:defibrotide; D014580:Ursodeoxycholic Acid