Early-onset hepatic veno-occlusive disease after liver transplantation: an institutional experience and analysis of a literature-based cohort

• Published in: Surgery Today Vol. 54; no. 7; pp. 670 - 682
• Main Authors: Yutaka, Endo, Masahiro, Shinoda, Junki, Maehara, Taizo, Hibi, Yasushi, Hasegawa, Hideaki, Obara, Minoru, Kitago, Hidenori, Ojima, Minoru, Tanabe, Yuko, Kitagawa
• Format: Journal Article
• Language: English
• Published: Singapore Springer Science and Business Media LLC 01.07.2024; Springer Nature Singapore
• Subjects: Adult; Cohort Studies; Female; Graft Rejection - epidemiology; Graft Survival; Hepatic Veno-Occlusive Disease - etiology; Humans; Liver Transplantation - adverse effects; Male; Medicine; Medicine & Public Health; Middle Aged; Original Article; Postoperative Complications - epidemiology; Postoperative Complications - etiology; Prognosis; Surgery; Surgical Oncology; Survival Rate; Time Factors; Prognosis; Survival rate; Pooled analysis; Hepatic veno-occlusive disease; Liver transplantation
• ISSN: 0941-1291; 1436-2813; 1436-2813
• DOI: 10.1007/s00595-023-02770-1

Purpose Hepatic veno-occlusive disease (HVOD) after liver transplantation (LT) is almost always a fatal complication. We assessed the outcomes of HVOD in a single institute and analyzed a literature-based cohort. Methods We reviewed the medical records of recipients of LT performed between 1995 and 2020 at our institute and the literature on HVOD after LT. We then analyzed the clinical features based on a “pooled” cohort of cases identified in our institute and reported in the literature. Results HVOD was diagnosed in 3 of 331 LT recipients, all of whom died in hospital, on days 164, 12, and 13, respectively. Our comprehensive review of the literature, as well as our cases, identified eight cases of HVOD that developed within 14 days after LT (early-onset type). Early-onset HVOD had a significantly worse prognosis than HVOD that developed beyond 2 weeks after LT (non-early-onset type), which was identified in 22 cases (25.0% vs. 86.1% of the 3-month graft survival rate). The most common causes of early-onset and non-early-onset types were acute cellular rejection (50%) and drug-induced disease (50%), respectively. Conclusion Early-onset HVOD developing within 14 days after LT has a poor prognosis.