Veno Occulsive disease: A potentially life threatening complication of hematopoietic stem cell transplantation
Year: 2006
Type: article
Abstract: Veno Occlusive disease (VOD) is a potentially life threatening liver complication occurring in up to 5% of patients undergoing hematopoietic stem cell transplantation (HSCT). It usually occurs before day +35 post transplant and presents with signs and symptoms including painful hepatomegaly, jaundice, fluid retention, weight gain of >5%, and ascites. Patients with VOD consume platelets, are often refractory to platelet transfusions and become coagulopathic. VOD occurs when the blood vessels of the liver become swollen and congested, diminishing the liver’s ability to remove toxins and waste from the blood. Fluids may build up in the liver causing additional swelling and tenderness (Mullaly K., 2002). Duke Low dose heparin infused continuously for the first 28 days post transplant ± actigall can be used as prophylaxis against VOD. Patients at high risk for VOD may be identified during the transplant workup and include those with prior liver disease, iron overload, decreased protein C, and heavily pretreated patients with malignancies. An attempt is made to avoid the use of hepatotoxic agents, but radiation, cytoxan, and busulfan are frequently necessary to treat the patient’s underlying disease. The use of defibrotide, an investigational agent with local thrombolytic activity, appears to be a safe and effective treatment options for patients with VOD. Studies have reported up to 50% of children responding favorably to treatment with defibrotide when significant VOD has occurred. Nurses play an important role in diagnosing VOD in pediatric patients by first monitoring strict IOs, daily weights, and pain reported by the patients on assessment. The purpose of this poster is to: (1) describe the signs and symptoms of Veno Occlusive disease; (2) state the treatment modalities currently used for treatment and prevention of VOD; and (3) describe important aspects of nursing care of the pediatric patient with VOD.
Institution: Duke Medical Center
Language: English
Subfield: Hematology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,650
OpenAlex ID: W1969237564