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

Bone Marrow Transplantation volume 28, pages 997–999 (2001)Cite this article

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. Bone Marrow Transplantation (2001) 28, 997–999.

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References

  1. McDonald GB, Sharma P, Matthews DE et al. Venocclusive disease of the liver after bone marrow transplantation: diagnosis, incidence, and predisposing factors Hepatology 1984 4: 116–122

    Article  CAS  PubMed  Google Scholar 

  2. Jones RJ, Lee KS, Beschorner WE et al. Venoocclusive disease of the liver following bone marrow transplantation Transplantation 1987 44: 778–783

    Article  CAS  PubMed  Google Scholar 

  3. Carreras E, Granena A, Rozman C . Hepatic veno-occlusive disease after bone marrow transplant Blood Rev 1993 7: 43–51

    Article  CAS  PubMed  Google Scholar 

  4. McDonald GB, Hinds MS, Fisher LD et al. Veno-occlusive disease of the liver and multiorgan failure after bone marrow transplantation: a cohort study of 355 patients Ann Intern Med 1993 118: 255–267

    Article  CAS  PubMed  Google Scholar 

  5. Bearman SI, Lee JL, Barón AE, McDonald GB . Treatment of hepatic venocclusive disease with recombinant human tissue plasminogen activator and heparin in 42 marrow transplant patients Blood 1997 89: 1501–1506

    CAS  PubMed  Google Scholar 

  6. Richardson PG, Elias AD, Krishnan A et al. Treatment of severe veno-occlusive disease with defibrotide: compassionate use results in response without significant toxicity in a high-risk population Blood 1998 92: 737–744

    CAS  PubMed  Google Scholar 

  7. Khoury H, Adkins D, Brown R et al. Does early treatment with high-dose methylprednisolone alter the course of hepatic regimen-related toxicity? Bone Marrow Transplant 2000 25: 737–743

    Article  CAS  PubMed  Google Scholar 

  8. Ringden O, Remberger M, Lehmann S et al. N-acetylcysteine for hepatic veno-occlusive disease after allogeneic stem cell transplantation Bone Marrow Transplant 2000 25: 993–996

    Article  CAS  PubMed  Google Scholar 

  9. Bearman SI, Shen DD, Hinds MS et al. A phase I/II study of prostaglandin E1 for the prevention of hepatic venocclusive disease after bone marrow transplantation Br J Haematol 1993 84: 724–730

    Article  CAS  PubMed  Google Scholar 

  10. Shulman HM, Gown AM, Nugent DJ . Hepatic veno-occlusive disease after bone marrow transplantation. Immunohistochemical identification of the material within occluded central venules Am J Pathol 1987 127: 549–558

    CAS  PubMed  PubMed Central  Google Scholar 

  11. Faioni EM, Mannucci PM . Venocclusive disease of the liver after bone marrow transplantation: the role of hemostasis Leuk Lymphoma 1997 25: 233–245

    Article  CAS  PubMed  Google Scholar 

  12. Vannucchi AM, Rafanelli D, Longo G et al. Early hemostatic alterations following bone marrow transplantation: a prospective study Haematologica 1994 79: 519–525

    CAS  PubMed  Google Scholar 

  13. Harper PL, Jarvis J, Jennings I et al. Changes in the natural anticoagulants following bone marrow transplantation Bone Marrow Transplant 1990 5: 39–42

    CAS  PubMed  Google Scholar 

  14. Testa S, Manna A, Porcellini A et al. Increased plasma level of vascular endothelial glycoprotein thrombomodulin as an early indicator of endothelial damage in bone marrow transplantation Bone Marrow Transplant 1996 18: 383–388

    CAS  PubMed  Google Scholar 

  15. Catani L, Gugliotta L, Vianelli N et al. Endothelium and bone marrow transplantation Bone Marrow Transplant 1996 17: 277–280

    CAS  PubMed  Google Scholar 

  16. Davis DR, Yeary RA, Lee K . Activated charcoal decreases plasma bilirubin levels in the hyperbilirubinemic rat Pediatr Res 1983 17: 208–209

    Article  CAS  PubMed  Google Scholar 

  17. Ash SR, Blake DE, Carr DJ et al. Clinical effects of a sorbent suspension dialysis system in treatment of hepatic coma (the BioLogic-DT) Int J Artif Org 1992 15: 151–161

    CAS  Google Scholar 

  18. Chen SC, Mullon C, Kahaku E et al. Treatment of severe liver failure with a bioartificial liver Ann NY Acad Sci 1997 831: 350–360

    Article  CAS  PubMed  Google Scholar 

  19. Ash SR, Blake DE, Carr DJ, Harker KD . Push–pull sorbent-based pheresis for treatment of acute hepatic failure: the BioLogic-detoxifier/plasma filter system Asaio J 1998 44: 129–139

    Article  CAS  PubMed  Google Scholar 

  20. Davis DR, Yeary RA . Activated charcoal as an adjunct to phototherapy for neonatal jaundice Dev Pharmacol Ther 1987 10: 12–20

    Article  CAS  PubMed  Google Scholar 

  21. O'Grady JG, Gimson AE, O'Brien CJ et al. Controlled trials of charcoal hemoperfusion and prognostic factors in fulminant hepatic failure Gastroenterology 1988 94: 1186–1192

    Article  CAS  PubMed  Google Scholar 

  22. Seda HW, Hughes RD, Gove CD, Williams R . Removal of inhibitors of brain Na+, K+-ATPase by hemoperfusion in fulminant hepatic failure Artif Org 1984 8: 174–178

    Article  CAS  Google Scholar 

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Authors and Affiliations

  1. Division of Hematology and Internal Medicine, Mayo Clinic, Rochester, MN, USA

    A Tefferi, S Kumar, MQ Lacy, DJ Inwards & MR Litzow

  2. Pharmacy Services, Mayo Clinic, Rochester, MN, USA

    RC Wolf

  3. Division of Nephrology and Internal Medicine, Mayo Clinic, Rochester, MN, USA

    JM Gloor & RC Albright

  4. Division of Gastroenterology and Hepatology and Internal Medicine, Mayo Clinic, Rochester, MN, USA

    PS Kamath

Authors
  1. A Tefferi
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  2. S Kumar
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  3. RC Wolf
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  5. DJ Inwards
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  9. MR Litzow
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Tefferi, A., Kumar, S., Wolf, R. et al. Charcoal hemofiltration for hepatic veno-occlusive disease after hematopoietic stem cell transplantation. Bone Marrow Transplant 28, 997–999 (2001). https://doi.org/10.1038/sj.bmt.1703267

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