Veno-occlusive Hepatic Disease (Sinusoidal Obstruction Syndrome) Follow-up

Updated: Apr 24, 2021
  • Author: James L Harper, MD; Chief Editor: Jennifer Reikes Willert, MD  more...
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Follow-up

Complications

Commonly observed complications include the following:

  • Hepatic failure: Some degree of hepatic dysfunction is observed in all cases of post-HSCT hepatic veno-occlusive disease/sinusoidal obstruction syndrome (VOD/SOS); however, in rare severe cases, overt liver failure may be observed.

  • Kidney failure: This may be secondary to hepatorenal syndrome, as well as direct injury by the vasculopathy. In patients who have undergone transplantation, numerous frequently used nephrotoxic drugs (eg, vancomycin, amphotericin B, cyclosporine) can result in preexisting renal dysfunction and loss of renal function reserve. Separating the effects of the drugs from the effects of VOD/SOS may be difficult.

  • Pulmonary failure

  • Neurologic compromise

  • Increased risk of infectious complications due to peritoneal drainage and transfer of an immunodeficient patient to intensive care with no laminar air flow units

  • Severe consumptive coagulopathy with an increased risk for thrombosis and bleeding