Veno-occlusive disease

Veno-occlusive disease (VOD) is a disease affecting the liver. VOD is a complication that occurs in up to 25% of bone marrow transplantations, and may also occur after ingestion of certain plant alkaloids.

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Features of VOD include weight gain, tender hepatomegaly, ascites, and increased bilirubin. It often is associated with renal failure. When associated with bone marrow transplant, VOD is fatal in over 30% of cases. Cases due to plant alkaloids often have a longer and more unpredictable course.

In the BMT setting, VOD is felt to be due to injury to the hepatic venous endothelium from the conditioning regimen. It is also known as sinuosoidal obstruction syndrome. Treatment for VOD is primarily supportive. In the BMT setting, defibrotide is an investigational treatment that may be promising. Defibrotide is a polydeoxyribonucleotide; its mechanism of benefit in VOD is unclear, but has been attributed to its antithrombotic properties.

References

• Kumar, V., Abbas, A. and N. Fausto. 2004. Robbins & Cotran Pathologic Basis of Disease. Philadelphia: W. B. Saunders Company