Sinusoidal obstruction syndrome (hepatic veno-occlusive disease)

Area of Science:

• Hepatology
• Oncology
• Transplantation Medicine

Background:

• Hepatic sinusoidal obstruction syndrome (SOS), also known as veno-occlusive disease (VOD), is a serious complication following certain medical treatments.
• It involves damage to liver sinusoidal endothelial cells (SEC) leading to venule occlusion and potential mortality.

Purpose of the Study:

• To review the pathogenesis, clinical presentation, diagnosis, treatment, and prevention strategies for hepatic sinusoidal obstruction syndrome.
• To highlight the critical nature of SOS and the need for comprehensive management.

Main Methods:

• Literature review of pathogenesis, clinical manifestations, diagnostic approaches, and therapeutic interventions for SOS.
• Discussion of preventative measures in high-risk patient populations.

Main Results:

• SOS is associated with cytoreductive therapy for HSCT, oxaliplatin chemotherapy, and herbal remedies.
• Pathogenesis involves SEC destruction, endothelial dysfunction, and activation of clotting factors.
• Clinical signs include jaundice, hepatomegaly, ascites, and weight gain.

Conclusions:

• Transjugular liver biopsy is often preferred for diagnosis to rule out other liver conditions.
• Treatment involves fluid management, medications like defibrotide, and potentially liver transplantation.
• Prevention strategies include modified HSCT protocols, ursodeoxycholic acid, and bevacizumab in chemotherapy regimens.