Successful Therapy of Transplant-associated Veno-occlusive Disease with a Combination of Tissue Plasminogen Activator and Defibrotide

Overview

Journal Med Oncol

Publisher Springer

Specialty Oncology

Date 2000 Dec 15

PMID 11114714

Citations 1

Authors

M J Jenner

I N Micallef

A Z Rohatiner

S M Kelsey

A C Newland

J D Cavenagh

Affiliations

Soon will be listed here.

Abstract

A 36-year-old man underwent matched unrelated donor bone marrow transplantation for chronic myeloid leukaemia. He developed severe hepatic veno-occlusive disease as an early post-transplant complication. Tissue plasminogen activator was initially felt to be contraindicated since the patient had concomitant pericarditis. Defibrotide was therefore commenced as treatment for veno-occlusive disease. The pericarditis improved but the veno-occlusive disease continued to worsen (peak bilirubin 353 micromol/l). Tissue plasminogen activator followed by a heparin infusion was therefore administered. However, he proceeded to develop haemorrhagic cardiac tamponade that required drainage. Thrombolysis was therefore discontinued and treatment with defibrotide resumed after an interval of 48 h. The veno-occlusive disease gradually resolved and defibrotide was discontinued once the bilirubin had plateaued. He was discharged home on day +52 post-transplant.

Citing Articles

Hepatic veno-occlusive disease after hematopoietic stem cell transplantation: Prophylaxis and treatment controversies.

Cheuk D World J Transplant. 2013; 2(2):27-34.

PMID: 24175193 PMC: 3782230. DOI: 10.5500/wjt.v2.i2.27.

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