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Related Experiment Videos

Multiple organ dysfunction syndrome in bone marrow transplantation

W D Haire1, E I Ruby, B G Gordon

  • 1Department of Internal Medicine, University of Nebraska Medical Center, Omaha 68198-3330, USA.

JAMA
|October 25, 1995
PubMed
Summary

Organ dysfunction in bone marrow transplantation (BMT) is common and linked to lower protein C (PC) and antithrombin III (ATIII) levels. These low levels are associated with increased mortality and organ failure, suggesting a role in BMT complications.

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Area of Science:

  • Hematology
  • Critical Care Medicine
  • Transplantation Immunology

Background:

  • Organ dysfunction is a significant complication following bone marrow transplantation (BMT).
  • The relationship between specific coagulation factors and organ dysfunction in BMT patients requires further elucidation.

Purpose of the Study:

  • To determine the incidence and outcomes of organ dysfunction in BMT patients.
  • To investigate whether reduced levels of protein C (PC) and antithrombin III (ATIII) are associated with organ dysfunction post-BMT.

Main Methods:

  • An inception cohort of 199 patients undergoing BMT was followed for 28 days or until hospital discharge/death.
  • Organ dysfunction (pulmonary, CNS, hepatic, renal) and levels of PC and ATIII were assessed.
  • Multivariate analysis was used to identify independent predictors of organ dysfunction.

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Main Results:

  • Single organ dysfunction occurred in 48.5% of patients and predicted multiple organ dysfunction syndrome (MODS) and death.
  • Lower levels of PC or ATIII were associated with increased mortality and organ dysfunction.
  • ATIII and PC levels independently predicted single organ dysfunction, irrespective of transplant type or bacteremia.

Conclusions:

  • Single organ dysfunction in BMT serves as a marker for systemic abnormalities and can progress to MODS.
  • MODS is a primary cause of death in BMT patients.
  • Reduced ATIII and PC levels are linked to MODS pathogenesis in BMT, highlighting their potential as biomarkers.