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Hepatic veno-occlusive disease.

B J Rollins

    The American Journal of Medicine
    |August 1, 1986
    PubMed
    Summary
    This summary is machine-generated.

    Hepatic veno-occlusive disease (HVOD) is a serious complication of chemotherapy, particularly bone marrow transplants. It involves liver vein blockage, leading to potential liver damage and significant mortality.

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    Area of Science:

    • Hepatology
    • Oncology
    • Transplantation Medicine

    Background:

    • Hepatic veno-occlusive disease (HVOD) is characterized by nonthrombotic obliteration of hepatic veins.
    • This condition can progress to hepatocellular necrosis, particularly following high-dose chemotherapy.
    • HVOD is a recognized complication of bone marrow transplantation, with incidence rates nearing 20%.

    Purpose of the Study:

    • To review the clinical presentation, diagnosis, and pathogenesis of hepatic veno-occlusive disease.
    • To highlight the increasing relevance of HVOD in the context of modern chemotherapy and transplantation protocols.
    • To discuss current supportive therapeutic strategies for liver veno-occlusive disease.

    Main Methods:

    • Review of existing literature and clinical case studies on hepatic veno-occlusive disease.

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  • Analysis of diagnostic criteria, including clinical presentation (jaundice, hepatomegaly, ascites) and confirmation via biopsy or autopsy.
  • Examination of proposed pathogenetic mechanisms, focusing on drug-induced endothelial damage.

    • Main Results:

    • The clinical diagnosis of HVOD is often accurate, based on a specific triad of symptoms.
    • Mortality rates associated with HVOD range significantly from 7% to 50%.
    • The pathogenesis is not fully understood but is strongly linked to chemotherapy-induced venous endothelial injury.

    Conclusions:

    • Hepatic veno-occlusive disease is an increasingly encountered complication of intensive chemotherapy and bone marrow transplantation.
    • Current management for HVOD is primarily supportive.
    • Further research into pathogenesis and targeted therapies is warranted given the rising incidence and associated mortality.