TY - JOUR AU - Castellino, Alessia AU - Guidi, Stefano AU - Dellacasa, Chiara AU - Gozzini, Antonella AU - Donnini, Irene AU - Nozzoli, Chiara AU - Manetta, Sara AU - Aydin, Semra AU - Giaccone, Luisa AU - Festuccia, Moreno AU - Brunello, Lucia AU - Maffini, Enrico AU - Bruno, Benedetto AU - David, Ezio AU - Busca, Alessandro PY - 2018/01/01 Y2 - 2024/03/28 TI - Late-onset hepatic veno-occlusive disease after allografting: report of two cases with atypical clinical features successfully treated with defibrotide. JF - Mediterranean Journal of Hematology and Infectious Diseases JA - Mediterr J Hematol Infect Dis VL - 10 IS - 1 SE - Case Reports DO - 10.4084/mjhid.2018.001 UR - https://www.mjhid.org/mjhid/article/view/2018.001 SP - e2018001 AB - <p>Hepatic Veno-occlusive disease (VOD) is a potentially severe complication of hematopoietic stem cell transplantation (HSCT). Here we report two patients receiving an allogeneic HSCT  who developed late onset VOD with atypical clinical features. The two  patients presented with only few risk factors, namely, advanced acute leukemia, a myeloablative busulphan-containing regimen and received grafts from an unrelated donor. The first patient did not experience painful hepatomegaly and weight gain and both  patients showed only a mild elevation in total serum bilirubin level. Most importantly, the two patients developed clinical signs beyond day 21 post-HSCT. Hepatic transjugular biopsy confirmed the diagnosis of VOD. Intravenous defibrotide was promptly started leading to a marked clinical improvement. Based on our experience, liver biopsy may represent a useful diagnostic tool when the clinical features of VOD are ambiguous. Early therapeutic intervention with defibrotide  represents a crucial issue for the successful outcome of patients with VOD.</p> ER -