Review
Copyright ©2012 Baishideng. All rights reserved.
World J Transplant. Apr 24, 2012; 2(2): 27-34
Published online Apr 24, 2012. doi: 10.5500/wjt.v2.i2.27
Hepatic veno-occlusive disease after hematopoietic stem cell transplantation: Prophylaxis and treatment controversies
Daniel KL Cheuk
Daniel KL Cheuk, Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, China
Author contributions: Cheuk DKL solely contributed to this paper.
Supported by The University of Hong Kong
Correspondence to: Daniel KL Cheuk, MD, FHKAM, Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Queen Mary Hospital, Pokfulam Road, Hong Kong, China. cheukkld@hkucc.hku.hk
Telephone: +852-22553909 Fax: +852-22551523
Received: June 8, 2011
Revised: October 18, 2011
Accepted: March 20, 2012
Published online: April 24, 2012
Abstract

Hepatic veno-occlusive disease (VOD), also known as sinusoidal obstruction syndrome, is a major complication of hematopoietic stem cell transplantation and it carries a high mortality. Prophylaxis for hepatic VOD is commonly given to transplant recipients from the start of conditioning through the early weeks of transplant. However, high quality evidence from randomized controlled trials is scarce with small sample sizes and the trials yielded conflicting results. Although various treatment options for hepatic VOD are available, most have not undergone stringent evaluation with randomized controlled trial and therefore it remains uncertain which treatment offers real benefit. It remains controversial whether VOD prophylaxis should be given, which prophylactic therapy should be given, who should receive prophylaxis, and what treatment should be offered once VOD is established.

Keywords: Hepatic veno-occlusive disease; Hematopoietic stem cell transplantation; Prophylaxis; Treatment; Randomized controlled trial