Smith F O, Johnson M S, Scherer L R, Faught P, Breitfeld P P, Albright E, Hillier S C, Gowan D, Smith P D, Robertson K A, Emanuel D
Riley Hospital for Children, Department of Pediatrics, Indianapolis, IN 46202-5225, USA.
Bone Marrow Transplant. 1996 Sep;18(3):643-6.
Severe veno-occlusive disease (VOD) of the liver is a frequent cause of morbidity and mortality in patients undergoing transplantation. While surgical portosystemic shunts have been reported to be useful in the treatment of severe hepatic VOD with intractable ascites, few of these patients are surgical candidates. We report a case of severe VOD after autologous peripheral blood progenitor cell transplantation treated with transjugular intrahepatic portosystemic shunting (TIPS). This procedure resulted in marked improvement in the patient's ascites, coagulation status and urinary output. The safety and efficacy of this non-surgical approach for the treatment of patients with severe VOD requires prospective studies.
严重肝静脉闭塞病(VOD)是移植患者发病和死亡的常见原因。虽然有报道称外科门体分流术可用于治疗伴有顽固性腹水的严重肝VOD,但这些患者中很少有人适合手术。我们报告一例自体外周血祖细胞移植后发生严重VOD的患者,经颈静脉肝内门体分流术(TIPS)治疗。该手术使患者的腹水、凝血状态和尿量显著改善。这种非手术方法治疗严重VOD患者的安全性和有效性需要进行前瞻性研究。