Article (Scientific journals)
The veno-occlusive disease of the liver.
Baron, Frédéric; Deprez, Manuel; Beguin, Yves
1997In Haematologica, 82 (6), p. 718-25
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Keywords :
Bone Marrow Transplantation/adverse effects; Diagnosis, Differential; Hepatic Veno-Occlusive Disease/diagnosis/etiology/physiopathology/therapy; Humans; Risk Factors
Abstract :
[en] BACKGROUND AND OBJECTIVE: The veno-occlusive disease of the liver (VOD) is a disorder caused by the non-thrombotic occlusion of the central veins of hepatic lobules. The clinical features are similar to those of intrahepatic portal hypertension (unexplained weight gain, ascites, painful hepatomegaly, jaundice). In the past, this disease was rather infrequent and was linked to the absorption of toxic agents, liver irradiation or chemotherapy. However, the intensification of treatment protocols before hematopoietic stem cell transplants has considerably increased its incidence. The strategies used for its prevention and treatment remain limited in efficacy. The present review was undertaken in order to assess progress in the diagnosis and management of this severe complication in stem cell transplantation. INFORMATION SOURCES: The method used for preparing this review was an examination of 250 relevant articles or abstracts published in journals covered by Medline. STATE OF ART: Despite the progress made toward the understanding of its physiopathology and the identification of its risk factors, VOD is still one of the leading causes of morbidity and mortality during the first two months post-BMT, and therefore often constitutes a limitation for the further increment of the dose of antineoplastic drugs. This may be explained by the difficulty in making an early diagnosis of this problem, at a time when therapeutic intervention may be more effective, and, on the other hand, the lack of a well-established prevention and treatment approach for patients with VOD. PERSPECTIVES AND CONCLUSIONS: New diagnostic procedures, such as laparoscopic liver biopsy, and new therapeutic approaches, such as transjugular intrahepatic portosystemic shunting (TIPS) or defibrotide, are now being evaluated. However, additional studies will be needed to determine the most appropriate therapy for each VOD patient depending on the severity of the disease.
Disciplines :
Hematology
Author, co-author :
Baron, Frédéric  ;  Centre Hospitalier Universitaire de Liège - CHU > Hématologie clinique
Deprez, Manuel ;  Université de Liège - ULiège > Département des sciences cliniques > Neuropathologie
Beguin, Yves  ;  Centre Hospitalier Universitaire de Liège - CHU > Hématologie clinique
Language :
English
Title :
The veno-occlusive disease of the liver.
Publication date :
1997
Journal title :
Haematologica
ISSN :
0390-6078
eISSN :
1592-8721
Publisher :
Ferrata Storti Foundation, Pavia, Italy
Volume :
82
Issue :
6
Pages :
718-25
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 25 February 2009

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