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Veno-occlusive disease (VOD) of the liver complicates 5% to 15% of allogeneic stem-cell transplants (SCTs). The disease is attributed to damage of hepatocytes and the hepatic sinusoidal endothelium and by the conditioning regimen used for myeloablative transplantation. Once apparent, VOD usually is treated with the antifibrinolytic agent defibrotide, albeit with only modest success. Known risk factors for VOD include advanced age, prior liver injury, and infusion of mismatched or unrelated donor stem cells. Another suspected risk factor is the use of sirolimus in SCT patients to prevent graft-versus-host disease (GVHD).
To investigate the potential association between use of sirolimus and GVHD, researchers assessed records of 488 patients wh…