Demonstration of reversed flow in segmental branches of the portal vein with hand-held color Doppler ultrasonography after hematopoietic stem cell transplantation

Hashiguchi, Michitoshi; Okamura, Takashi; Yoshimoto, Kohji; Ono, Naofumi; Imamura, Rie; Yakushiji, Kazuaki; Ogata, Hideaki; Seki, Ritsuko; Otsubo, Korenori; Oku, Eijiro; Kuroiwa, Mika; Higuchi, Masakazu; Katô, Kôji; Taniguchi, Shuichi; Gondo, Hisashi; Shibuya, T; Nagafuji, Koji; Harada, Mine; Sata, Michio

doi:10.1038/sj.bmt.1705170

Cited by 15 publications

(10 citation statements)

References 22 publications

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“…Brown et al (1990) reported that reversed portal venous flow represents one of the late and severe changes in patients with clinically evident VOD. Hashiguchi et al (2005) reported that 6 of 9 patients did not fulfill the diagnostic criteria when the reversed portal venous flow was first detected. Color Doppler ultrasound is also helpful in diagnosing or excluding BuddÀChiari syndrome.…”

Section: Review Of the Literaturementioning

confidence: 99%

New Ultrasound Techniques Challenge the Diagnosis of Sinusoidal Obstruction Syndrome

Dietrich

Trenker

Fontanilla

et al. 2018

Ultrasound in Medicine & Biology

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Sinusoidal obstruction syndrome, also known as veno-occlusive disease (SOS/VOD), is a potentially life-threatening complication that can develop after hematopoietic cell transplantation. Clinically, SOS/VOD is characterized by hepatomegaly, right upper quadrant pain, jaundice and ascites, most often occurring within the first 3 wk after hematopoietic cell transplantation. Early therapeutic intervention is pivotal for survival in SOS/VOD. Thus, a rapid and reliable diagnosis has to be made. Diagnosis of SOS/VOD is based on clinical criteria, such as the Seattle, Baltimore or recently issued European Society for Blood and Marrow Transplantation criteria, to which hemodynamic and/or ultrasound evidence of SOS were added for the first time. However, to rule out major differential diagnoses and to verify the diagnosis, a reliable imaging method is needed. Ultrasound techniques have been proposed in SOS/VOD. Nevertheless, the sensitivity and specificity of transabdominal ultrasound and Doppler techniques need to be improved. Innovative ultrasound methods such as a combination of Doppler ultrasound with shear wave elastography and contrast-enhanced ultrasound techniques should be evaluated for diagnosis and follow-up of SOS/VOD. The goals of this review are to discuss currently available ultrasound techniques and to identify areas for future studies in SOS/VOD.

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Section: Review Of the Literaturementioning

confidence: 99%

New Ultrasound Techniques Challenge the Diagnosis of Sinusoidal Obstruction Syndrome

Dietrich

Trenker

Fontanilla

et al. 2018

Ultrasound in Medicine & Biology

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“…Most of these studies have used non‐specific markers and it is suggested that the main role of ultrasound is to exclude the presence of other diagnoses. Reported abnormalities have included thickening of the gallbladder wall, reversal of portal vein blood flow, ascites, hepatomegaly and splenomegaly (Brown et al , ; Herbetko et al , ; Hommeyer et al , ; Benya et al , ; Teefey et al , ; Lassau et al , ; Hashiguchi et al , ). Although several prospective studies have been undertaken, these investigations have failed to show consistent results (reviewed in Mahgerefteh et al , ).…”

Section: Diagnosismentioning

confidence: 99%

BCSH/BSBMT guideline: diagnosis and management of veno‐occlusive disease (sinusoidal obstruction syndrome) following haematopoietic stem cell transplantation

et al. 2013

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Summary of Key Recommendations Diagnosis It is recommended that the diagnosis of veno‐occlusive disease (sinusoidal obstruction syndrome) [VOD (SOS)] be based primarily on established clinical criteria (modified Seattle or Baltimore criteria) (1A). Ultrasound imaging may be helpful in the exclusion of other disorders in patients with suspected VOD (SOS) (1C). It is recommended that liver biopsy be reserved for patients in whom the diagnosis of VOD (SOS) is unclear and there is a need to exclude other diagnoses (1C). It is recommended that liver biopsies are undertaken using the transjugular approach in order to reduce the risks associated with the procedure (1C). It is suggested that the role of plasminogen activator inhibitor 1 levels remains an area for further research but that these levels should not form part of the routine diagnostic work‐up for VOD (SOS) at present (2C). Risk factors It is recommended that patients are assessed for risk factors for VOD (SOS) and that these risk factors are addressed prior to haematopoietic stem cell transplantation (1A). Prophylaxis Defibrotide is recommended at a dose of 6·25 mg/kg intravenously four times daily for the prevention of VOD (SOS) in children undergoing allogeneic stem cell transplantation with the following risk factors: pre‐existing hepatic disease, second myeloablative transplant, allogeneic transplant for leukaemia beyond second relapse, conditioning with busulfan‐containing regimens, prior treatment with gemtuzumab ozogamicin, diagnosis of primary haemophagocytic lymphohistiocytosis, adrenoleucodystrophy or osteopetrosis (1A). Defibrotide is suggested at a dose of 6·25 mg/kg intravenously four times daily for the prevention of VOD (SOS) in adults undergoing allogeneic stem cell transplantation with the following risk factors: pre‐existing hepatic disease, second myeloablative transplant, allogeneic transplant for leukaemia beyond second relapse, conditioning with busulfan‐containing regimens, prior treatment with gemtuzumab ozogamicin, diagnosis of primary haemophagocytic lymphohistiocytosis, adrenoleucodystrophy or osteopetrosis (2B). Prostaglandin E1 is not recommended in the prophylaxis of VOD (SOS) due to lack of efficacy and toxicity (1B). Pentoxifylline is not recommended in the prophylaxis of VOD (SOS) due to lack of efficacy (1A). Ursodeoxycholic acid is suggested for use in the prophylaxis of VOD (SOS) (2C). Heparin (unfractionated and low molecular weight) is not suggested for use in the prophylaxis of VOD (SOS) due to the risk of increased toxicity (2B). Antithrombin is not suggested for the prophylaxis of VOD (SOS) due to lack of efficacy (2B). Treatment Defibrotide is recommended in the treatment of VOD (SOS) in adults and children (1B). Tissue plasminogen activator is not recommended for use in the treatment of VOD (SOS) due to the associated risk of haemorrhage (1B). N‐acetylcysteine is not routinely recommended for use in the treatment of veno‐occlusive disease due to lack of efficacy (1A). Methylprednisolone may be consider...

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“…Several authors declared that the measurement of portal flow was no use for diagnosing the disease (8,9). During this century, however, results that support the diagnostic usefulness of Doppler US for SOS have been dominant (10,11). Improvement of the equipment could explain the change.…”

Section: Discussionmentioning

confidence: 99%

Regorafenib could cause sinusoidal obstruction syndrome

Takahashi

Harada

Suzuki

et al. 2016

J. Gastrointest. Oncol.

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A 74-year-old man with advanced colon cancer was admitted to our hospital with jaundice and ascites. Four weeks before admission, he had started treatment with regorafenib because other chemotherapies had failed. Blood tests showed a characteristic increase in his serum lactate dehydrogenase level, which indicated intrahepatic hypoxia. The liver was not cirrhotic, but Doppler ultrasonography (US) showed that the portal flow was markedly decreased. These findings suggested that his liver failure could be caused by sinusoidal obstruction syndrome (SOS). We therefore started treatment with anticoagulants that included antithrombin III and recombinant thrombomodulin. His portal flow gradually increased, and his hepatic function improved in parallel with the increased flow. Although regorafenib could cause fatal liver failure, the mechanism remains unclear. SOS might be a route by which regorafenib induces liver failure. Additionally, lactate dehydrogenase could be a marker for identifying the adverse effects at an early stage of regorafenib-induced liver failure.

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Demonstration of reversed flow in segmental branches of the portal vein with hand-held color Doppler ultrasonography after hematopoietic stem cell transplantation

Cited by 15 publications

References 22 publications

New Ultrasound Techniques Challenge the Diagnosis of Sinusoidal Obstruction Syndrome

New Ultrasound Techniques Challenge the Diagnosis of Sinusoidal Obstruction Syndrome

BCSH/BSBMT guideline: diagnosis and management of veno‐occlusive disease (sinusoidal obstruction syndrome) following haematopoietic stem cell transplantation

Regorafenib could cause sinusoidal obstruction syndrome

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