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Hepatobiliary disease after bone marrow transplant
Maria Gabriela Fernandes Dezan1,2, Lourianne Nascimento Cavalcante1,2, Helma Pinchemel Cotrim2
1Instituto D'Or de Pesquisa e Ensino (IDOR) and Hospital São Rafael Gastro-Hepatology Service, Hospital São Rafael, Salvador, Bahia, Brazil.
Expert Review of Gastroenterology & Hepatology
|January 19, 2023
Summary
Bone marrow transplantation (BMT) can lead to serious liver complications. Early diagnosis and understanding of causes like drug-induced liver injury and GVHD are crucial for better patient outcomes.
Area of Science:
- Hepatology
- Hematology
- Transplantation Medicine
Background:
- Bone marrow transplantation (BMT) is a standard treatment for hematologic diseases.
- Post-BMT patients are susceptible to diverse hepatobiliary complications, significantly affecting morbidity and mortality.
- Differential diagnoses include drug-induced liver injury (DILI), sepsis-associated liver injury (SALI), sinusoidal obstruction syndrome (SOS), and graft-versus-host disease (GVHD).
Approach:
- A literature review was conducted focusing on early hepatobiliary complications post-BMT.
- The PubMed database was searched using terms related to hepatic complications, BMT, and specific liver conditions.
- The review aimed to consolidate understanding of clinical characteristics and diagnostic challenges.
Key Points:
- Hepatobiliary injury post-BMT presents a diagnostic challenge due to overlapping symptoms.
- Accurate diagnosis requires careful consideration of medication history, liver enzyme levels, and infection status.
- Understanding the temporality of events and applying specific diagnostic criteria are essential.
Conclusions:
- Early hepatobiliary complications following BMT require a comprehensive diagnostic approach.
- Awareness of various potential etiologies is critical for effective clinical management.
- Timely and accurate diagnosis can lead to improved patient outcomes in BMT recipients.
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