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[Veno-occlusive disease of the liver]

Malwina Rybicka1, Robert Krysiak, Bogusław Okopień

  • 1Klinika Chorób Wewnetrznych i Farmakologii Klinicznej Katedry Farmakologii Slaskiego Uniwersytetu Medycznego w Katowicach. malwinarybicka@poczta.onet.pl

Wiadomosci Lekarskie (Warsaw, Poland : 1960)
|October 13, 2009
PubMed

Insights

Veno-occlusive disease (VOD) obstructs liver blood flow in bone marrow transplant patients, causing serious complications. Early detection and effective treatments are crucial due to high mortality rates in severe cases.

Area of Science:

  • Hepatology
  • Transplantation Medicine
  • Vascular Biology

Context:

  • Veno-occlusive disease (VOD), also known as sinusoidal obstruction syndrome (SOS), is a significant complication following hematopoietic stem cell transplantation (HSCT).
  • It is characterized by the occlusion of hepatic sinusoids and small hepatic veins, leading to liver congestion and hepatomegaly.
  • VOD affects bone marrow transplant recipients, with incidence and severity varying based on conditioning regimens and patient factors.

Purpose:

  • To describe the pathophysiology, clinical presentation, grading, and prognostic markers of Veno-occlusive disease (VOD) in bone marrow transplant recipients.
  • To highlight the clinical significance of VOD as a cause of mortality post-transplantation.
  • To emphasize the need for improved VOD prophylaxis and treatment strategies.

Summary:

  • VOD involves obstruction of hepatic sinusoidal and centrolobular venous outflow due to liver vessel endothelial injury.
  • Clinical manifestations include jaundice, portal hypertension, peripheral edema, and weight gain.
  • Disease severity is graded mild, moderate, or severe, with serum bilirubin and weight gain rates serving as key indicators within the first two weeks.

Impact:

  • Severe VOD is a leading cause of mortality in bone marrow transplant survivors.
  • Limited therapeutic options underscore the importance of VOD prophylaxis and the development of more effective treatments.
  • Understanding VOD's clinical markers aids in timely intervention and patient management, potentially improving outcomes.

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