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Clinical diagnosis of veno-occlusive disease using contrast enhanced ultrasound

Bone Marrow Transplantation volume 53, pages 1369–1371 (2018)Cite this article

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Veno-occlusive disease (VOD), also known as hepatic sinusoidal obstruction syndrome (SOS), defines a disease based on an incomplete obstruction of sinusoids and venules with the development of portal hypertension. VOD/SOS is a severe disease and often represents a complication of allogeneic stem cell transplantation. The mortality is high (80 %) [1, 2]. The pathogenesis is not fully understood. Radiotherapy or high-dose chemotherapy is presumed to be the cause [2]. Clinically, the disease is characterized by weight gain, hepatomegaly with epigastric pain, ascites, and an increase of serum bilirubin [1, 2]. Acute renal failure may also occur[1, 2]. Two research groups (Seattle and Baltimore) have described generally accepted diagnostic criteria [1].

However, diagnosis and the decision to initiate treatment are mainly clinical based. Gold standard in the diagnosis is the histological evaluation by means of liver biopsy, which cannot be carried out in everyday clinical practice if the patient’s general condition is poor due to impaired coagulation after allogeneic stem cell transplantation [3]. In addition, biopsy and histological evaluation is time consuming which may cause treatment delay.

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References

  1. Matsumoto Y, Horiike S, Sakagami J, Fujimoto Y, Taniguchi K, Shimizu D, et al. Early ultrasonographic diagnosis and clinical follow-up of hepatic veno-occlusive disease after allogeneic bone marrow transplantation in a patient with acute lymphoblastic leukemia. Intern Med. 2009;48:831–5.

    Article  Google Scholar 

  2. Negrin SR, Bonis PAL. Diagnosis of hepatic sinusoidal obstruction syndrome (veno-occlusive disease) following hematopoietic cell transplantation. 2017. https://www.uptodate.com/contents/diagnosis-of-hepatic-sinusoidal-obstruction.

  3. Lassau N, Koscielny S, Avril M-F, Margulis A, Duvillard P, De Baere T, et al. Prognostic value of angiogenesis evaluated with high-frequency and color Doppler sonography for preoperative assessment of melanomas. AJR Am J Roentgenol Am Roentgen Ray Soc. 2002;178:1547–51.

    Article  Google Scholar 

  4. Claudon M, Dietrich CF, Choi BI, Cosgrove DO, Kudo M, Nolsøe CP, et al. Guidelines and good clinical practice recommendations for contrast enhanced ultrasound (CEUS) in the liver–update 2012: a WFUMB-EFSUMB initiative in cooperation with representatives of AFSUMB, AIUM, ASUM, FLAUS and ICUS. Ultraschall Med Georg Thieme Verl KG. 2013;34:11–29.

    CAS  Google Scholar 

  5. Lassau N, Leclère J, Auperin A, Bourhis JH, Hartmann O, Valteau-Couanet D, et al. Hepatic veno-occlusive disease after myeloablative treatment and bone marrow transplantation: value of gray-scale and Doppler US in 100 patients. Radiology. 1997;204:545–52.

    Article  CAS  Google Scholar 

  6. Fontanilla T, Hernando CG, Claros JCV, Bautista G, Minaya J, Del Carmen Vega M, et al. Acoustic radiation force impulse elastography and contrast-enhanced sonography of sinusoidal obstructive syndrome (veno-occlusive disease): preliminary results. J Ultrasound Med. 2011;30:1593–8.

    Article  Google Scholar 

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Authors and Affiliations

  1. Klinik für Hämatologie, Onkologie und Immunologie, Universitätsklinikum Marburg und Gießen, Standort Marburg und Philipps Universität Marburg, Marburg, Germany

    C. Trenker & K. Sohlbach

  2. Med Klinik 2, Caritas-Krankenhaus Bad Mergenheim, Bad Mergenheim, Germany

    C. F. Dietrich

  3. Interdisziplinäres Ultraschallzentrum, Universitätsklinikum Marburg und Gießen, Standort Marburg und Philipps Universität Marburg, Marburg, Germany

    C. Görg

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  1. C. Trenker
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  2. K. Sohlbach
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  4. C. Görg
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Correspondence to C. Trenker.

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Conflict of interest

Bracco Imaging supported workshops of contrast enhanced ultrasound at the University Hospital in Marburg. CG received funding from Bracco Imaging for the workshops. The workshops conduce for education of medical doctors. The remaining authors declare that they have no conflict of interest.

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Trenker, C., Sohlbach, K., Dietrich, C.F. et al. Clinical diagnosis of veno-occlusive disease using contrast enhanced ultrasound. Bone Marrow Transplant 53, 1369–1371 (2018). https://doi.org/10.1038/s41409-018-0198-1

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