Hepatic veno-occlusive disease

Hepatic veno-occlusive disease (VOD) or veno-occlusive disease with immunodeficiency is a potentially life-threatening condition in which some of the small veins in the liver are obstructed. It is a complication of high-dose chemotherapy given before a bone marrow transplant and/or excessive exposure to hepatotoxic pyrrolizidine alkaloids. It is classically marked by weight gain due to fluid retention, increased liver size, and raised levels of bilirubin in the blood. The name sinusoidal obstruction syndrome (SOS) is preferred if hepatic veno-occlusive disease happens as a result of chemotherapy or bone marrow transplantation.

Hepatic veno-occlusive disease
Other namesVeno-occlusive disease with immunodeficiency
Sinusoidal obstruction syndrome
SpecialtyGastroenterology 
SymptomsWeight gain, tender enlargement of the liver, ascites, jaundice
Diagnostic methodLiver biopsy
Differential diagnosisBudd–Chiari syndrome
PreventionUrsodeoxycholic acid
TreatmentDefibrotide
Deaths10-20%

Apart from chemotherapy, hepatic veno-occlusive disease may also occur after ingestion of certain plant alkaloids such as pyrrolizidine alkaloids (in some herbal teas), and has been described as part of a rare hereditary disease called hepatic venoocclusive disease with immunodeficiency (which results from mutations in the gene coding for a protein called SP110).

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