Journal of Bioequivalence & Bioavailability

Abstract

Hepatic Sinusoidal Obstruction Syndrome/Veno-Occlusive Disease after Hematopoietic Stem Cell Transplantation in Pediatric Patients: A Review of Assessment for Liver Stiffness Measurement by Elastography along with Defibrotide Efficacy

Kazumi Fujioka*

The updated criteria in adult patients with the addition of a new category such as probable Sinusoidal Obstruction Syndrome/Veno-Occlusive Disease (SOS/VOD) included ultrasound and/or elastography criteria. The European Society for Blood and Marrow Transplantation (EBMT) has stated a new classification of the diagnosis and severity for SOS/VOD in pediatric patients, but this did not include elastography criteria. The MEDLINE/PubMed and EMBASE data-bases were systematically searched for studies using elastography for SOS/VOD after Hematopoietic Stem Cell Transplantation (HSCT) in pediatric patients. In this review, the author summarized the current evidence of SOS/VOD in pediatric patients after HSCT for assessment of Liver Stiffness Measurement (LSM) by elastography along with the utility of defibrotide for treatment and prevention. Based on the evidence, Shear Wave Elastography (SWE) and Transient Elastography (TE) are probably potential tools for early accurate diagnosis and disease severity for SOS/VOD after HSCT even in pediatric patients. It is putative that LSM value should be considered as diagnostic criteria for predicting the SOS/VOD in pediatric study. Defibrotide may be a promising therapeutic strategy for SOS/VOD after HSCT in pediatric patients.

Published Date: 2026-04-22; Received Date: 2026-03-23