Consensus Report by Pediatric Acute Lung Injury and Sepsis Investigators and Pediatric Blood and Marrow Transplantation Consortium Joint Working Committees: Supportive Care Guidelines for Management of Veno-Occlusive Disease in Children and Adolescents, Part 1: Focus on Investigations, Prophylaxis, and Specific Treatment

Rajinder P.S. Bajwa, Kris M. Mahadeo, Benjamin H. Taragin, Christopher C. Dvorak, Jennifer McArthur, Asumthia Jeyapalan, Christine N. Duncan, Robert Tamburro, Alison Gehred, Leslie Lehmann, Paul Richardson, Jeffery J. Auletta, Ann E. Woolfrey

Research output: Contribution to journalReview article

8 Scopus citations

Abstract

Veno-occlusive disease (VOD) is a common and potentially fatal complication in children undergoing hematopoietic cell transplantation (HCT). It occurs in about one-third of all patients undergoing transplantation and is fatal in 50% of patients with severe disease. Early intervention and specific treatment with defibrotide are associated with improved outcomes. However, there is a lack of supportive care guidelines for management of the multiorgan dysfunction seen in most cases. There is high variability in the management of VOD, which may contribute to the increased morbidity and mortality. Although there is ample research in the specific treatment of VOD, there is paucity of literature regarding the management of ascites, transfusions requirements, fluids and electrolyte dysfunction, delirium, and investigations in children with VOD. The joint working committees of the Pediatric Acute Lung Injury and Sepsis Investigators and the Pediatric Blood and Marrow Transplantation Consortium collaborated to develop a series of evidence-based supportive care guidelines for management of VOD. The quality of evidence was rated and recommendations were made using Grading of Recommendations, Assessment, Development and Evaluation criteria. This manuscript is part 1 of the series and focuses on the need to develop these guidelines; methodology used to establish the guidelines; and investigations needed for diagnosis, prophylaxis, and treatment of VOD in children.

Original languageEnglish (US)
Pages (from-to)1817-1825
Number of pages9
JournalBiology of Blood and Marrow Transplantation
Volume23
Issue number11
DOIs
StatePublished - Nov 2017

Keywords

  • Defibrotide
  • Diagnosis
  • Prophylaxis
  • Sinusoidal obstruction syndrome
  • Ultrasonography
  • Veno-occlusive disease

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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