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Post-Transplant Complications

A randomized trial of heparin plus ursodiol vs heparin alone to prevent hepatic veno-occlusive disease after hematopoietic stem cell transplantation

Bone Marrow Transplantation volume 29, pages 137–143 (2002)Cite this article

Abstract

Hepatic veno-occlusive disease (VOD) is a common and serious regimen-related toxicity after hematopoietic stem cell transplantation (HSCT). There is no safe and proven therapy for established VOD, and focus has been on its prevention. Previous studies have shown that a continuous infusion of unfractionated heparin or ursodiol may reduce the incidence of VOD. In order to compare the efficacy of heparin plus ursodiol with that of heparin alone, we conducted a prospective, randomized study involving 165 consecutive patients who underwent HSCT for a variety of disorders. Eighty-two patients were assigned to receive heparin plus ursodiol, and 83 were assigned to receive heparin alone. Thirteen and 16 patients were diagnosed as having VOD in the heparin plus ursodiol group and the heparin alone group, respectively (15.9% vs 19.3%; P = 0.348). Eighty-nine percent of the heparin plus ursodiol group and 89.2% of the heparin alone group were surviving at day 100 post-HSCT (P = 0.298). The only independent variable associated with an increased risk of VOD was an allogeneic type of HSCT (P = 0.018). In conclusion, this study shows that there is no difference in efficacy between heparin plus ursodiol and heparin alone for the prevention of hepatic VOD.

Bone Marrow Transplantation (2002) 29, 137–143. doi:10.1038/sj.bmt.1703342

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Acknowledgements

We thank Meen Jong Lee and So Yeon Seol for assistance in manuscript preparation.

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Authors and Affiliations

  1. Division of Hematology and Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

    SH Park, MH Lee, K Kim, WS Kim, CW Jung, YH Im, SS Yoon, WK Kang, K Park & CH Park

  2. Blood and Marrow Transplantation Program, Cancer Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

    MH Lee, H Lee, HS Kim, K Kim, WS Kim & CW Jung

  3. Samsung Biomedical Research Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

    SW Kim

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Park, S., Lee, M., Lee, H. et al. A randomized trial of heparin plus ursodiol vs heparin alone to prevent hepatic veno-occlusive disease after hematopoietic stem cell transplantation. Bone Marrow Transplant 29, 137–143 (2002). https://doi.org/10.1038/sj.bmt.1703342

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