Low incidence of hepatic veno-occlusive disease in pediatric patients undergoing hematopoietic stem cell transplantation attributed to a combination of intravenous heparin, oral glutamine, and ursodiol at a single transplant institution

Authors


Indira Sahdev, MD, Division of Pediatric Hematology/Oncology & Stem Cell Transplantation, Schneider Children’s Hospital, North Shore-Long Island Jewish Health System, Suite 255, 269-01, 76th Avenue, New Hyde Park, NY 11040, USA
Tel.: 718-470-3606
Fax: 718-343-2961
E-mail: Isahdev@nshs.edu

Abstract

Lakshminarayanan S, Sahdev I, Goyal M, Vlachos A, Atlas M, Lipton JM. Low incidence of hepatic veno-occlusive disease in pediatric patients undergoing hematopoietic stem cell transplantation attributed to a combination of intravenous heparin, oral glutamine, and ursodiol at a single transplant institution.
Pediatr Transplantation 2010: 14:618–621. © 2009 John Wiley & Sons A/S.

Abstract:  We report the low incidence of hepatic VOD in pediatric patients with various diagnoses including hematologic malignancies and non-malignant conditions transplanted at our institution. Retrospective review of 188 patients who underwent HSCT and received a combined prophylactic regimen of intravenous heparin, oral glutamine, and ursodiol was undertaken. Analysis of the outcome of VOD revealed only one clinical case with acute myeloid leukemia; the patient developed hepatic VOD 10 days after receiving myeloablative chemotherapy with busulfan and CTX followed by HLA-matched related peripheral blood stem cell transplantation. The low incidence of hepatic VOD in an otherwise high-risk pediatric transplant population is an important observation, which may be partly attributed to this prophylactic regimen, and warrants further randomized clinical trials for confirmation.

Ancillary