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How I manage sinusoidal obstruction syndrome after haematopoietic cell transplantation
Author(s) -
Carreras Enric
Publication year - 2015
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/bjh.13215
Subject(s) - defibrotide , medicine , intensive care medicine , transplantation , haematopoiesis , hepatic veno occlusive disease , disease , hematopoietic cell , hematopoietic stem cell transplantation , immunology , stem cell , surgery , biology , genetics
Summary Sinusoidal obstruction syndrome ( SOS ), also called veno‐occlusive disease of the liver, is one of the most relevant complications of endothelial origin that appears early after haematopoietic cell transplantation ( HCT ). Despite its relatively low incidence and the fact that most cases of SOS resolve spontaneously, the cases that evolve to multi‐organ failure ( MOF ; severe SOS ) have a mortality rate higher than 80% and represent one of the major clinical problems after HCT . For this reason, transplantation teams must have a pre‐established policy regarding preventive measures in high‐risk patients, strict daily control of weight and fluid balance during HCT , homogeneous diagnostic criteria, appropriate complementary studies for a correct differential diagnosis and measures to prevent and manage hepatorenal syndrome; in addition they must also be ready to start early treatment with defibrotide in patients with a possible severe SOS . Due to the lack of definitive evidence to enable the establishment of general recommendations in the management of SOS , this review analyses all of these aspects based on the author's personal experience.