Background & objective: Veno-occlusive disease of the liver (VOD) is one of the most common complications in patients after hematopoietic stem cell transplantation (HSCT). So far, the mortality of severe VOD is almost 100%. How to deal with the disease remains to be an unresolved problem. This study was to explore more efficient methods of prevention and treatment of VOD.
Methods: Clinical data of 18 patients undergoing allogeneic HSCT were analyzed. All the patients were pretreated with busulfan and cyclophosphamide, and treated with prostaglandin E1, glutathione and ornithine aspartate before HSCT to prevent VOD. Prostagland E1, low molecular weight heparin and tissue plasminogen activator (tPA) were used to treat the patient with VOD.
Results: The serum level of glutamate-pyruvate transaminase was elevated in 11 patients after HSCT, and all the patients were cured. Only 1 patient suffered VOD which was severe. Prostaglandin E1 and low molecular weight heparin were not effective in this case, while tPA was. The side effect of tPA was bleeding of the skin and mucosa.
Conclusions: The combination of prostaglandin E1, glutathione and ornithine aspartate is probably effective and safe in preventing VOD for it aims at many aspects of pathogenesis of VOD. tPA can be used carefully as a choice of treating severe VOD.