Charcoal hemofiltration for hepatic veno-occlusive disease after hematopoietic stem cell transplantation

A. Tefferi, S. Kumar, R. C. Wolf, M. Q. Lacy, D. J. Inwards, J. M. Gloor, R. C. Albright, P. S. Kamath, M. R. Litzow

Research output: Contribution to journalArticle

15 Scopus citations

Abstract

Hepatic veno-occlusive disease (HVOD) after hematopoietic stem cell transplantation (HSCT) results in considerable morbidity and mortality. No therapy has been shown to be uniformly effective. Several studies have highlighted the pivotal role of endothelial injury and the hemostatic system in the pathogenesis of HVOD. Charcoal hemofiltration has been shown to be effective for adsorbing circulating bilirubin and other protein-bound toxins and for supporting patients in hepatic failure. We describe two adult patients with severe, biopsy-proven HVOD (peak bilirubin levels, more than 50 mg/dl in both cases) after HSCT who were successfully treated with charcoal hemofiltration after other treatments failed (including defibrotide in one patient). Both patients were heavily treated before they underwent either autologous (melphalan and total body irradiation conditioning) or allogeneic (cyclophosphamide and total body irradiation conditioning) HSCT. Additional studies are warranted to confirm this preliminary observation and investigate the mechanism of action.

Original languageEnglish (US)
Pages (from-to)997-999
Number of pages3
JournalBone Marrow Transplantation
Volume28
Issue number10
DOIs
StatePublished - Dec 22 2001

Keywords

  • Charcoal hemoperfusion treatment
  • Transplant-related complication

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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