Editorial
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World J Gastroenterol. Apr 28, 2012; 18(16): 1851-1860
Published online Apr 28, 2012. doi: 10.3748/wjg.v18.i16.1851
Gastrointestinal and hepatic complications of hematopoietic stem cell transplantation
Hande H Tuncer, Naveed Rana, Cannon Milani, Angela Darko, Samer A Al-Homsi
Hande H Tuncer, Naveed Rana, Cannon Milani, Samer A Al-Homsi, Division of Hematological Malignancies and Blood and Marrow Transplantation, Roger Williams Medical Center, Providence, RI 02908, United States
Hande H Tuncer, Naveed Rana, Cannon Milani, Angela Darko, Samer A Al-Homsi, Boston University School of Medicine, Boston, MA 02203, United States
Angela Darko, Department of Pathology, Roger Williams Medical Center, Providence, RI 02908, United States
Author contributions: Tuncer HH made substantial contributions to conception and design, drafting the article and revising it critically for important intellectual content; Rana N and Milani C contributed to drafting the article and collecting patient sample data; Darko A provided the pathology slides; Al-Homsi SA revised the article; all authors approved the version to be published.
Correspondence to: Dr. Hande H Tuncer, Division of Hematological Malignancies and Blood and Marrow Transplantation, Roger Williams Medical Center, 825 Chalkstone Avenue, Providence, RI 02908, United States. htuncer@rwmc.org
Telephone: +1-401-4566565 Fax: +1-401-4567693
Received: June 27, 2011
Revised: November 15, 2011
Accepted: December 31, 2011
Published online: April 28, 2012
Abstract

Recognition and management of gastrointestinal and hepatic complications of hematopoietic stem cell transplantation has gained increasing importance as indications and techniques of transplantation have expanded in the last few years. The transplant recipient is at risk for several complications including conditioning chemotherapy related toxicities, infections, bleeding, sinusoidal obstruction syndrome, acute and chronic graft-versus-host disease (GVHD) as well as other long-term problems. The severity and the incidence of many complications have improved in the past several years as the intensity of conditioning regimens has diminished and better supportive care and GVHD prevention strategies have been implemented. Transplant clinicians, however, continue to be challenged with problems arising from human leukocyte antigen-mismatched and unrelated donor transplants, expanding transplant indications and age-limit. This review describes the most commonly seen transplant related complications, focusing on their pathogenesis, differential diagnosis and management.

Keywords: Stem cell transplantation; Graft-versus-host disease; Sinusoidal obstruction syndrome; Complications