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  • Title: [Prevention of hepatic veno-occlusive disease by a combination of heparin and prostaglandin E1 in children undergoing hematopoietic stem cell transplantation].
    Author: Inukai T, Sugita K, Goi K, Akahane K, Hirose K, Nemoto A, Takahashi K, Sato H, Uno K, Furuichi Y, Nakamura M, Miyamoto N, Yamakawa N, Shiraishi K, Kojika S, Tezuka T, Iijima K, Nakazawa S.
    Journal: Rinsho Ketsueki; 2004 Apr; 45(4):297-303. PubMed ID: 15168445.
    Abstract:
    The effect and safety of combination prophylaxis for hepatic veno-occlusive disease (VOD) following stem cell transplantation (SCT) was retrospectively evaluated in a total of 53 children who survived until day 30. Prophylaxis was started on the day before conditioning, and heparin (10 unit/kg/hr) alone was used in 6 patients, PGE1 (5 ng/kg/min) plus heparin plus PTX (200 mg/day) in 17 patients, lipo-PGE1 (0.5 ng/kg/min) plus heparin plus PTX in 7 patients, and lipo-PGE1 plus heparin in 23 patients. Diagnosis of VOD was made based on McDonald's criteria in 5 cases (9.4%), but not on Jones' criteria. No statistically significant difference was observed in the incidence of VOD among each prophylaxis group. The degree of VOD was mild in all of 5 cases, and all recovered with continuation of the prophylactic procedure. Each prophylactic procedure was performed without any significant adverse effect except for seizure induced by lipo-PGE1 in one patient with Lennox syndrome. Since both the incidence and fatality rate of VOD in children undergoing SCT are approximately 20% according to most of the previous reports, the present study suggests the effectiveness of combination prophylaxis.
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