hepatic veno-occlusive disease; sinusoidal obstruction syndrome

Etiology

• cytotoxic agents
  • complicates 5-15% of allogeneic stem-cell transplants
  • cyclophosphamide
  • other chemotherapeutic agents
  • herbal teas
    • pennroyal
    • germander
    • chaprral leaf
    • comfry
    • jin bu huan
• risk factors
  • advanced age
  • prior liver injury
  • infusion of mismatched or unrelated donor stem cells
• sirolimus to prevent graft-versus-host disease (GVHD).

Pathology

• damage of hepatocytes & the hepatic sinusoidal endothelium

Management

• usually treated with antifibrinolytic agent defibrotide, with only modest success
• liver transplantation in refractory cases

More general terms

• veno-occlusive disease
• liver disease