The advances in hematopoietic cell transplantation (HCT) over the last decade have led to a transplant-related mortality below 15%. Hepatic sinusoidal obstruction syndrome/veno-occlusive disease (SOS/VOD) is a life-threatening complication of HCT that belongs to a group of diseases increasingly identified as transplant-related, systemic endothelial diseases. In most cases, SOS/VOD resolves within weeks; however, severe SOS/VOD results in multi-organ dysfunction/failure with a mortality rate >80%. A timely diagnosis of SOS/VOD is of critical importance, given the availability of therapeutic options with favorable tolerability. Current diagnostic criteria are used for adults and children. However, over the last decade it has become clear that SOS/VOD is significantly different between the age groups in terms of incidence, genetic predisposition, clinical presentation, prevention, treatment and outcome. Improved understanding of SOS/VOD and the availability of effective treatment questions the use of the Baltimore and Seattle criteria for diagnosing SOS/VOD in children. The aim of this position paper is to propose new diagnostic and severity criteria for SOS/VOD in children on behalf of the European Society for Blood and Marrow Transplantation.

Children's Hospital University of Helsinki Helsinki Finland

Department of Clinical Haematology Manchester Royal Infirmary Manchester UK

Department of Haematology King's College Hospital London UK

Department of Hematology and Immunology Hospital Robert Debre Paris 7 Paris Diderot University Paris France

Department of Pediatric Hematology and Oncology University of Pavia IRCCS Ospedale Pediatrico Bambino Gesù Rome Italy

Department of Pediatric Hematology Oncology and Hematopoietic Stem Cell Transplantation University of Medical Sciences Poznan Poland

Department of Pediatric Hematology Oncology and Stem Cell Transplantation University of Regensburg Regensburg Germany

Department of Pediatric Oncohematology Giambattista Rossi University Hospital Verona Italy

Department of Pediatrics Leiden University Medical Center Leiden The Netherlands

Department of Pediatrics St Anna Kinderspital Vienna Austria

Department of Pediatrics University Children's Hospital Ulm Germany

Department of Pediatrics University Hospital Motol Prague Czech Republic

Department of Pediatrics University Hospital of Jena Jena Germany

Division for Stem Cell Transplantation and Immunology Department for Children and Adolescents University Hospital Goethe University Frankfurt Main Germany

Division of Blood and Marrow Transplantation University Children's Hospital Zurich Switzerland

Division of Hematologic Malignancy Department of Medical Oncology Dana Farber Cancer Institute Boston MA USA

Hemato Oncology Unit Department of Pediatrics University Hospital of Geneva Geneva Switzerland

Hematology Department Josep Carreras Foundation and Leukemia Research Institute Hospital Clínic Barcelona Spain

Hôpital Saint Antoine APHP Université Pierre and Marie Curie INSERM UMRS 938 Paris France

Pediatric Clinic University of Milano Bicocca San Gerardo Hospital Milan Italy

Pediatric Hematology Oncology Children's Hospital Medical School Hannover Germany

Pediatric Stem Cell Transplantation Unit Bahçeşehir University School of Medicine Istanbul Turkey

Royal Hospital for Sick Children Glasgow UK

Royal Manchester Children's Hospital Manchester UK

Schneider Children's Medical Center of Israel and Sackler Faculty of Medicine University of Tel Aviv Tel Aviv Israel

Section of Hematology and Coagulation Sahlgrenska University Hospital Gothenburg Sweden

Skåne University Hospital Lund Sweden

University Hospital and Polytechnic La Fe Valencia Spain

Zobrazit více v PubMed

Boztug H, Sykora KW, Slatter M, Zecca M, Veys P, Lankester A et al. European Society for Blood and Marrow Transplantation analysis of treosulfan conditioning before hematopoietic stem cell transplantation in children and adolescents with hematological malignancies. Pediatr Blood Cancer 2016; 63: 139–148. PubMed

Helmy A. Review article: updates in the pathogenesis and therapy of hepatic sinusoidal obstruction syndrome. Aliment Pharmacol Ther 2006; 23: 11–25. PubMed

Fan CQ, Crawford JM. Sinusoidal obstruction syndrome (hepatic veno-occlusive disease). J Clin Exp Hepatol 2014; 4: 332–346. PubMed PMC

Carreras E, Diaz-Ricart M. The role of the endothelium in the short-term complications of hematopoietic SCT. Bone Marrow Transplant 2011; 46: 1495–1502. PubMed

McKoy JM, Angelotta C, Bennett CL, Tallman MS, Wadleigh M, Evens AM et al. Gemtuzumab ozogamicin-associated sinusoidal obstructive syndrome (SOS): An overview from the research on adverse drug events and reports (RADAR) project. Leuk Res 2007; 31: 599–604. PubMed

Wadleigh M, Richardson PG, Zahrieh D, Lee SJ, Cutler C, Ho V et al. Prior gemtuzumab ozogamicin exposure significantly increases the risk of veno-occlusive disease in patients who undergo myeloablative allogeneic stem cell transplantation. Blood 2003; 102: 1578–1582. PubMed

Kebriaei P, Wilhelm K, Ravandi F, Brandt M, de Lima M, Ciurea S et al. Feasibility of allografting in patients with advanced acute lymphoblastic leukemia after salvage therapy with inotuzumab ozogamicin. Clin Lymphoma Myeloma Leuk 2013; 13: 296–301. PubMed PMC

Cefalo MG, Maurizi P, Arlotta A, Scalzone M, Attina G, Ruggiero A et al. Hepatic veno-occlusive disease: a chemotherapy-related toxicity in children with malignancies. Paediatr Drugs 2010; 12: 277–284. PubMed

Cesaro S, Spiller M, Sartori MT, Alaggio R, Peruzzo M, Saggiorato G et al. Veno-occlusive disease in pediatric patients affected by Wilms tumor. Pediatr Blood Cancer 2011; 57: 258–261. PubMed

Nazemi KJ, Shen V, Finlay JL, Boyett J, Kocak M, Lafond D et al. High incidence of veno-ccclusive disease with myeloablative chemotherapy following craniospinal irradiation in children with newly diagnosed high-risk CNS embryonal tumors: a report from the Children's Oncology Group (CCG-99702). Pediatr Blood Cancer 2016; 63: 1563–1570. PubMed PMC

Stork LC, Matloub Y, Broxson E, La M, Yanofsky R, Sather H et al. Oral 6-mercaptopurine versus oral 6-thioguanine and veno-occlusive disease in children with standard-risk acute lymphoblastic leukemia: report of the Children's Oncology Group CCG-1952 clinical trial. Blood 2010; 115: 2740–2748. PubMed PMC

Huezo-Diaz Curtis P, Uppugunduri CR, Muthukumaran J, Rezgui MA, Peters C, Bader P et al. Association of CTH variant with sinusoidal obstruction syndrome in children receiving intravenous busulfan and cyclophosphamide before hematopoietic stem cell transplantation. Pharmacogenomics J (e-pub ahead of print 25 October 2016; doi: 10.1038/tpj.2016.65). PubMed PMC

Seifert C, Wittig S, Arndt C, Gruhn B. Heparanase polymorphisms: influence on incidence of hepatic sinusoidal obstruction syndrome in children undergoing allogeneic hematopoietic stem cell transplantation. J Cancer Res Clin Oncol 2015; 141: 877–885. PubMed

Palomo M, Mir E, Rovira M, Escolar G, Carreras E, Diaz-Ricart M. What is going on between defibrotide and endothelial cells? Snapshots reveal the hot spots of their romance. Blood 2016; 127: 1719–1727. PubMed PMC

Corbacioglu S, Cesaro S, Faraci M, Valteau-Couanet D, Gruhn B, Rovelli A et al. Defibrotide for prophylaxis of hepatic veno-occlusive disease in paediatric haemopoietic stem-cell transplantation: an open-label, phase 3, randomised controlled trial. Lancet 2012; 379: 1301–1309. PubMed

Coppell JA, Richardson PG, Soiffer R, Martin PL, Kernan NA, Chen A et al. Hepatic veno-occlusive disease following stem cell transplantation: incidence, clinical course, and outcome. Biol Blood Marrow Transplant 2010; 16: 157–168. PubMed PMC

Richardson PG, Riches ML, Kernan NA, Brochstein JA, Mineishi S, Termuhlen AM et al. Phase 3 trial of defibrotide for the treatment of severe veno-occlusive disease and multi-organ failure. Blood 2016; 127: 1656–1665. PubMed PMC

Lee JL, Gooley T, Bensinger W, Schiffman K, McDonald GB. Veno-occlusive disease of the liver after busulfan, melphalan, and thiotepa conditioning therapy: incidence, risk factors, and outcome. Biol Blood Marrow Transplant 1999; 5: 306–315. PubMed

Carreras E, Rosinol L, Terol MJ, Alegre A, de Arriba F, Garcia-Larana J et al. Veno-occlusive disease of the liver after high-dose cytoreductive therapy with busulfan and melphalan for autologous blood stem cell transplantation in multiple myeloma patients. Biol Blood Marrow Transplant 2007; 13: 1448–1454. PubMed

Akil A, Zhang Q, Mumaw CL, Raiker N, Yu J, Velez de Mendizabal N et al. Biomarkers for diagnosis and prognosis of sinusoidal obstruction syndrome after hematopoietic cell transplantation. Biol Blood Marrow Transplant 2015; 21: 1739–1745. PubMed PMC

Iguchi A, Kobayashi R, Kaneda M, Kobayashi K. Plasma protein C is a useful clinical marker for hepatic veno-occlusive disease (VOD) in stem cell transplantation. Pediatr Blood Cancer 2010; 54: 437–443. PubMed

Cutler C, Kim HT, Ayanian S, Bradwin G, Revta C, Aldridge J et al. Prediction of veno-occlusive disease using biomarkers of endothelial injury. Biol Blood Marrow Transplant 2010; 16: 1180–1185. PubMed PMC

Sartori MT, Spiezia L, Cesaro S, Messina C, Paris M, Pillon M et al. Role of fibrinolytic and clotting parameters in the diagnosis of liver veno-occlusive disease after hematopoietic stem cell transplantation in a pediatric population. Thromb Haemost 2005; 93: 682–689. PubMed

Tanikawa S, Mori S, Ohhashi K, Akiyama H, Sasaki T, Kaku H et al. Predictive markers for hepatic veno-occlusive disease after hematopoietic stem cell transplantation in adults: a prospective single center study. Bone Marrow Transplant 2000; 26: 881–886. PubMed

Mortele KJ, Van Vlierberghe H, Wiesner W, Ros PR. Hepatic veno-occlusive disease: MRI findings. Abdom Imaging 2002; 27: 523–526. PubMed

Lassau N, Auperin A, Leclere J, Bennaceur A, Valteau-Couanet D, Hartmann O. Prognostic value of doppler-ultrasonography in hepatic veno-occlusive disease. Transplantation 2002; 74: 60–66. PubMed

McCarville MB, Hoffer FA, Howard SC, Goloubeva O, Kauffman WM. Hepatic veno-occlusive disease in children undergoing bone-marrow transplantation: usefulness of sonographic findings. Pediatr Radiol 2001; 31: 102–105. PubMed

Jones RJ, Lee KS, Beschorner WE, Vogel VG, Grochow LB, Braine HG et al. Venoocclusive disease of the liver following bone marrow transplantation. Transplantation 1987; 44: 778–783. PubMed

McDonald GB, Sharma P, Matthews DE, Shulman HM, Thomas ED. Venocclusive disease of the liver after bone marrow transplantation: diagnosis, incidence, and predisposing factors. Hepatology 1984; 4: 116–122. PubMed

McDonald GB, Hinds MS, Fisher LD, Schoch HG, Wolford JL, Banaji M et al. Veno-occlusive disease of the liver and multiorgan failure after bone marrow transplantation: a cohort study of 355 patients. Ann Intern Med 1993; 118: 255–267. PubMed

Shulman HM, Hinterberger W. Hepatic veno-occlusive disease—liver toxicity syndrome after bone marrow transplantation. Bone Marrow Transplant 1992; 10: 197–214. PubMed

Mohty M, Malard F, Abecassis M, Aerts E, Alaskar AS, Aljurf M et al. Sinusoidal obstruction syndrome/veno-occlusive disease: current situation and perspectives-a position statement from the European Society for Blood and Marrow Transplantation (EBMT). Bone Marrow Transplant 2015; 50: 781–789. PubMed PMC

Carreras E, Bertz H, Arcese W, Vernant JP, Tomas JF, Hagglund H et al. Incidence and outcome of hepatic veno-occlusive disease after blood or marrow transplantation: a prospective cohort study of the European Group for Blood and Marrow Transplantation. European Group for Blood and Marrow Transplantation Chronic Leukemia Working Party. Blood 1998; 92: 3599–3604. PubMed

Carreras E, Diaz-Beya M, Rosinol L, Martinez C, Fernandez-Aviles F, Rovira M. The incidence of veno-occlusive disease following allogeneic hematopoietic stem cell transplantation has diminished and the outcome improved over the last decade. Biol Blood Marrow Transplant 2011; 17: 1713–1720. PubMed

Yakushijin K, Atsuta Y, Doki N, Yokota A, Kanamori H, Miyamoto T et al. Sinusoidal obstruction syndrome after allogeneic hematopoietic stem cell transplantation: Incidence, risk factors and outcomes. Bone Marrow Transplant 2016; 51: 403–409. PubMed

Barker CC, Butzner JD, Anderson RA, Brant R, Sauve RS. Incidence, survival and risk factors for the development of veno-occlusive disease in pediatric hematopoietic stem cell transplant recipients. Bone Marrow Transplant 2003; 32: 79–87. PubMed

Cesaro S, Pillon M, Talenti E, Toffolutti T, Calore E, Tridello G et al. A prospective survey on incidence, risk factors and therapy of hepatic veno-occlusive disease in children after hematopoietic stem cell transplantation. Haematologica 2005; 90: 1396–1404. PubMed

Corbacioglu S, Honig M, Lahr G, Stohr S, Berry G, Friedrich W et al. Stem cell transplantation in children with infantile osteopetrosis is associated with a high incidence of VOD, which could be prevented with defibrotide. Bone Marrow Transplant 2006; 38: 547–553. PubMed

Richardson PG, Elias AD, Krishnan A, Wheeler C, Nath R, Hoppensteadt D et al. Treatment of severe veno-occlusive disease with defibrotide: compassionate use results in response without significant toxicity in a high-risk population. Blood 1998; 92: 737–744. PubMed

Richardson PG, Murakami C, Jin Z, Warren DL, Momtaz P, Hoppensteadt D et al. Multi-institutional use of defibrotide in 88 patients post stem cell transplant with severe veno-occlusive disease and multi-system organ failure; response without significant toxicity in a high risk population and factors predictive of outcome. Blood 2002; 100: 4337–4343. PubMed

Richardson PG, Soiffer RJ, Antin JH, Uno H, Jin Z, Kurtzberg J et al. Defibrotide for the treatment of severe hepatic veno-occlusive disease and multi-organ failure post stem cell transplantation: a multi-center, randomized, dose-finding trial. Biol Blood Marrow Transplant 2010; 16: 1005–1017. PubMed PMC

Zhang L, Wang Y, Huang H. Defibrotide for the prevention of hepatic veno-occlusive disease after hematopoietic stem cell transplantation: a systematic review. Clin Transplant 2012; 26: 511–519. PubMed

Dignan F, Gujral D, Ethell M, Evans S, Treleaven J, Morgan G et al. Prophylactic defibrotide in allogeneic stem cell transplantation: minimal morbidity and zero mortality from veno-occlusive disease. Bone Marrow Transplant 2007; 40: 79–82. PubMed

Versluys B, Bhattacharaya R, Steward C, Cornish J, Oakhill A, Goulden N. Prophylaxis with defibrotide prevents veno-occlusive disease in stem cell transplantation after gemtuzumab ozogamicin exposure. Blood 2004; 103: 1968. PubMed

Chalandon Y, Roosnek E, Mermillod B, Newton A, Ozsahin H, Wacker P et al. Prevention of veno-occlusive disease with defibrotide after allogeneic stem cell transplantation. Biol Blood Marrow Transplant 2004; 10: 347–354. PubMed

Richardson P, Smith A, Triplett B, Kernan N, Grupp S, Antin J et al. Treatment of hepatic veno-occlusive disease/sinusoidal obstruction syndrome (VOD/SOS) post-hematopoietic stem cell transplantation (HSCT) in patients with acute leukemias: a subgroup analysis from the defibrotide expanded-access program ASH. Annual Meeting Abstracts 2016; 128: 3412.

Corbacioglu S, Carreras E, Mohty M, Pagliuca A, Boelens JJ, Damaj G et al. Defibrotide for the treatment of hepatic veno-occlusive disease: final results from the international compassionate-use program. Biol Blood Marrow Transplant 2016; 22: 1874–1882. PubMed

Corbacioglu S, Greil J, Peters C, Wulffraat N, Laws HJ, Dilloo D et al. Defibrotide in the treatment of children with veno-occlusive disease (VOD): a retrospective multicentre study demonstrates therapeutic efficacy upon early intervention. Bone Marrow Transplant 2004; 33: 189–195. PubMed

Grupp S, Smith A, Triplett B, Kernan N, Antin J, Lehmann L et al. Timingof initiation of defibrotide post-diagnosis of hepatic veno-occlusive disease/sinusoidal obstruction syndrome post-hematopoietic stem cell transplantation: exploratory age-group analysis from an expanded access study. ASH, Annual Meeting Abstracts 2016; 128: 66.

Mohty M, Malard F, Abecassis M, Aerts E, Alaskar AS, Aljurf M et al. Revised diagnosis and severity criteria for sinusoidal obstruction syndrome/veno-occlusive disease in adult patients: a new classification from the European Society for Blood and Marrow Transplantation. Bone Marrow Transplant 2016; 51: 906–912. PubMed PMC

Hogan WJ, Maris M, Storer B, Sandmaier BM, Maloney DG, Schoch HG et al. Hepatic injury after nonmyeloablative conditioning followed by allogeneic hematopoietic cell transplantation: a study of 193 patients. Blood 2004; 103: 78–84. PubMed

Nagler A, Labopin M, Berger R, Bunjes D, Campos A, Socie G et al. Allogeneic hematopoietic SCT for adults AML using i.v. BU in the conditioning regimen: outcomes and risk factors for the occurrence of hepatic sinusoidal obstructive syndrome. Bone Marrow Transplant 2014; 49: 628–633. PubMed

Bartelink IH, Lalmohamed A, van Reij EM, Dvorak CC, Savic RM, Zwaveling J et al. Association of busulfan exposure with survival and toxicity after haemopoietic cell transplantation in children and young adults: a multicentre, retrospective cohort analysis. Lancet Haematol 2016; 3: e526–e536. PubMed PMC

Uppugunduri CR, Rezgui MA, Diaz PH, Tyagi AK, Rousseau J, Daali Y et al. The association of cytochrome P450 genetic polymorphisms with sulfolane formation and the efficacy of a busulfan-based conditioning regimen in pediatric patients undergoing hematopoietic stem cell transplantation. Pharmacogenomics J 2014; 14: 263–271. PubMed

Bredeson C, LeRademacher J, Kato K, Dipersio JF, Agura E, Devine SM et al. Prospective cohort study comparing intravenous busulfan to total body irradiation in hematopoietic cell transplantation. Blood 2013; 122: 3871–3878. PubMed PMC

Okamoto Y, Nagatoshi Y, Kosaka Y, Kikuchi A, Kato S, Kigasawa H et al. Prospective pharmacokinetic study of intravenous busulfan in hematopoietic stem cell transplantation in 25 children. Pediatr Transplant 2014; 18: 294–301. PubMed

Malar R, Sjoo F, Rentsch K, Hassan M, Gungor T. Therapeutic drug monitoring is essential for intravenous busulfan therapy in pediatric hematopoietic stem cell recipients. Pediatr Transplant 2011; 15: 580–588. PubMed

Veal GJ, Nguyen L, Paci A, Riggi M, Amiel M, Valteau-Couanet D et al. Busulfan pharmacokinetics following intravenous and oral dosing regimens in children receiving high-dose myeloablative chemotherapy for high-risk neuroblastoma as part of the HR-NBL-1/SIOPEN trial. Eur J Cancer 2012; 48: 3063–3072. PubMed

Schulz AS, Classen CF, Mihatsch WA, Sigl-Kraetzig M, Wiesneth M, Debatin KM et al. HLA-haploidentical blood progenitor cell transplantation in osteopetrosis. Blood 2002; 99: 3458–3460. PubMed

Ouachee-Chardin M, Elie C, de Saint Basile G, Le Deist F, Mahlaoui N, Picard C et al. Hematopoietic stem cell transplantation in hemophagocytic lymphohistiocytosis: a single-center report of 48 patients. Pediatrics 2006; 117: e743–e750. PubMed

Cheuk DK, Wang P, Lee TL, Chiang AK, Ha SY, Lau YL et al. Risk factors and mortality predictors of hepatic veno-occlusive disease after pediatric hematopoietic stem cell transplantation. Bone Marrow Transplant 2007; 40: 935–944. PubMed

Li CK, Shing MM, Chik KW, Lee V, Leung TF, Cheung AY et al. Haematopoietic stem cell transplantation for thalassaemia major in Hong Kong: prognostic factors and outcome. Bone Marrow Transplant 2002; 29: 101–105. PubMed

Mathews V, George B, Deotare U, Lakshmi KM, Viswabandya A, Daniel D et al. A new stratification strategy that identifies a subset of class III patients with an adverse prognosis among children with beta thalassemia major undergoing a matched related allogeneic stem cell transplantation. Biol Blood Marrow Transplant 2007; 13: 889–894. PubMed

Horn B, Reiss U, Matthay K, McMillan A, Cowan M. Veno-occlusive disease of the liver in children with solid tumors undergoing autologous hematopoietic progenitor cell transplantation: a high incidence in patients with neuroblastoma. Bone Marrow Transplant 2002; 29: 409–415. PubMed

Qayed M, Chiang KY, Ricketts R, Alazraki A, Tahvildari A, Haight A et al. Tandem stem cell rescue as consolidation therapy for high-risk neuroblastoma. Pediatr Blood Cancer 2012; 58: 448–452. PubMed

Yasui N, Kawamoto H, Fujiwara M, Aihara Y, Ogawa C, Hosono A et al. High-dose chemotherapy for high-risk retinoblastoma: clinical course and outcome of 14 cases in the National Cancer Center, Japan. Bone Marrow Transplant 2015; 50: 221–224. PubMed

Elli M, Pinarli FG, Dagdemir A, Acar S. Veno-occlusive disease of the liver in a child after chemotherapy for brain tumor. Pediatr Blood Cancer 2006; 46: 521–523. PubMed

Sulis ML, Bessmertny O, Granowetter L, Weiner M, Kelly KM. Veno-occlusive disease in pediatric patients receiving actinomycin D and vincristine only for the treatment of rhabdomyosarcoma. J Pediatr Hematol Oncol 2004; 26: 843–846. PubMed

Czauderna P, Katski K, Kowalczyk J, Kurylak A, Lopatka B, Skotnicka-Klonowicz G et al. Venoocclusive liver disease (VOD) as a complication of Wilms' tumour management in the series of consecutive 206 patients. Eur J Pediatr Surg 2000; 10: 300–303. PubMed

Schechter T, Finkelstein Y, Doyle J, Verjee Z, Moretti M, Koren G et al. Pharmacokinetic disposition and clinical outcomes in infants and children receiving intravenous busulfan for allogeneic hematopoietic stem cell transplantation. Biol Blood Marrow Transplant 2007; 13: 307–314. PubMed

Toh HC, McAfee SL, Sackstein R, Cox BF, Colby C, Spitzer TR. Late onset veno-occlusive disease following high-dose chemotherapy and stem cell transplantation. Bone Marrow Transplant 1999; 24: 891–895. PubMed

Pai RK, van Besien K, Hart J, Artz AS, O'Donnell PH. Clinicopathologic features of late-onset veno-occlusive disease/sinusoidal obstruction syndrome after high dose intravenous busulfan and hematopoietic cell transplant. Leuk Lymphoma 2012; 53: 1552–1557. PubMed PMC

Myers KC, Dandoy C, El-Bietar J, Davies SM, Jodele S. Veno-occlusive disease of the liver in the absence of elevation in bilirubin in pediatric patients after hematopoietic stem cell transplantation. Biol Blood Marrow Transplant 2015; 21: 379–381. PubMed PMC

Naples J, Skeens M, Bajwa R. Anicteric hepatic veno-occlusive disease after hematopoietic stem cell transplantation in children. Blood 2014; 124: 5849–5849. PubMed

Carreras E. How I manage sinusoidal obstruction syndrome after haematopoietic cell transplantation. Br J Haematol 2015; 168: 481–491. PubMed

Carreras E, Granena A, Navasa M, Bruguera M, Marco V, Sierra J et al. On the reliability of clinical criteria for the diagnosis of hepatic veno-occlusive disease. Ann Hematol 1993; 66: 77–80. PubMed

Hod E, Schwartz J. Platelet transfusion refractoriness. Br J Haematol 2008; 142: 348–360. PubMed

Rio B, Andreu G, Nicod A, Arrago JP, Dutrillaux F, Samama M et al. Thrombocytopenia in venocclusive disease after bone marrow transplantation or chemotherapy. Blood 1986; 67: 1773–1776. PubMed

Bearman SI. The syndrome of hepatic veno-occlusive disease after marrow transplantation. Blood 1995; 85: 3005–3020. PubMed

Nash RA, Gooley T, Davis C, Appelbaum FR. The problem of thrombocytopenia after hematopoietic stem cell transplantation. Oncologist 1996; 1: 371–380. PubMed

Norol F, Kuentz M, Cordonnier C, Beaujean F, Haiouin C, Vernant JP et al. [Influence of clinical status on the efficacy of stored platelet transfusion]. Rev Fr Transfus Hemobiol 1993; 36: 427–437. PubMed

Hommeyer SC, Teefey SA, Jacobson AF, Higano CS, Bianco JA, Colacurcio CJ et al. Venocclusive disease of the liver: prospective study of US evaluation. Radiology 1992; 184: 683–686. PubMed

Mahgerefteh SY, Sosna J, Bogot N, Shapira MY, Pappo O, Bloom AI. Radiologic imaging and intervention for gastrointestinal and hepatic complications of hematopoietic stem cell transplantation. Radiology 2011; 258: 660–671. PubMed

Carreras E, Granena A, Navasa M, Bruguera M, Marco V, Sierra J et al. Transjugular liver biopsy in BMT. Bone Marrow Transplant 1993; 11: 21–26. PubMed

Shulman HM, Gooley T, Dudley MD, Kofler T, Feldman R, Dwyer D et al. Utility of transvenous liver biopsies and wedged hepatic venous pressure measurements in sixty marrow transplant recipients. Transplantation 1995; 59: 1015–1022. PubMed

Teefey SA, Brink JA, Borson RA, Middleton WD. Diagnosis of venoocclusive disease of the liver after bone marrow transplantation: value of duplex sonography. AJR Am J Roentgenol 1995; 164: 1397–1401. PubMed

Sharafuddin MJ, Foshager MC, Steinbuch M, Weisdorf DJ, Hunter DW. Sonographic findings in bone marrow transplant patients with symptomatic hepatic venoocclusive disease. J Ultrasound Med 1997; 16: 575–586. PubMed

Kriegshauser JS, Charboneau JW, Letendre L. Hepatic venocclusive disease after bone-marrow transplantation: diagnosis with duplex sonography. AJR Am J Roentgenol 1988; 150: 289–290. PubMed

Hashiguchi M, Okamura T, Yoshimoto K, Ono N, Imamura R, Yakushiji K et al. Demonstration of reversed flow in segmental branches of the portal vein with hand-held color Doppler ultrasonography after hematopoietic stem cell transplantation. Bone Marrow Transplant 2005; 36: 1071–1075. PubMed

Skeens MA, McArthur J, Cheifetz IM, Duncan C, Randolph AG, Stanek J et al. Highvariability in the reported management of hepatic veno-occlusive disease in children after hematopoietic stem cell transplantation. Biol Blood Marrow Transplant 2016; 22: 1823–1828. PubMed

Oshrine B, Lehmann LE, Duncan CN. Safety and utility of liver biopsy after pediatric hematopoietic stem cell transplantation. J Pediatr Hematol Oncol 2011; 33: e92–e97. PubMed

Chao N. How I treat sinusoidal obstruction syndrome. Blood 2014; 123: 4023–4026. PubMed

Bearman SI, Anderson GL, Mori M, Hinds MS, Shulman HM, McDonald GB. Venoocclusive disease of the liver: development of a model for predicting fatal outcome after marrow transplantation. J Clin Oncol 1993; 11: 1729–1736. PubMed

Dignan FL, Wynn RF, Hadzic N, Karani J, Quaglia A, Pagliuca A et al. BCSH/BSBMT guideline: diagnosis and management of veno-occlusive disease (sinusoidal obstruction syndrome) following haematopoietic stem cell transplantation. Br J Haematol 2013; 163: 444–457. PubMed

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