Hepatic Veno-occlusive Disease after Bone Marrow Transplantation in Leukemic Patients: Two Cases Proven by Laparoscopic Liver Biopsy

Kim, Bo Kyoung; Choi, Hwang; Kim, Byung Wook; Choi, Ji Hyen; Park, Jae Myung; Ju, Ji Hyen; Choi, Myung Gyu; Kim, Jae Kwang; Kang, Chagn Suk; Min, Woo Sung; Kim, Chun Choo; Chung, Kyu Won

Abstract

The clinical syndrome of venoocclusive disease of the liver is one of several manifestations of regimen-related toxicity that can occur after high-dose cytoreductive therapy. Hepatic dysfunction after bone marrow transplantation may result from a number of causes such as pretransplant chemoradiation, graft-versus host disease, drugs for prophylaxis of graft-versus host disease, venoocclusive disease, various infections, and infiltration of recurrent malignancy. The clinical distinction of these causes may be difficult and the treatment of each cause is also quite different. Therefore the diagnosis of veno-occlusive disease is important. Veno-occlusive disease affects zone 3 of the liver acinus and produces a syndrome of jaundice, painful hepatomegaly, and fluid retention. Veno-occlusive disease occurs in up to 50% of the patients who undergo BMT and is usually associated with a high mortality rate. In Korea, there are a few case reports on venoocclusive disease after BMT which were only confirmed by clinical symptoms. This is a first report of two cases of hepatic veno-occlusive disease after allogenic BMT, which were proven by laparoscopic liver biopsy in our country.