TIPS for Venoocclusive Disease Following Stem Cell Transplantation

Zusammenfassung

Venoocclusive disease (VOD) kann als Komplikation der Stammzelltransplantation auftreten. Dem Doppler-Ultraschall wird ein prognostischer Wert bei VOD zugeschrieben. Wir berichten über eine 39-jährige Patientin mit VOD nach allogener Stammzelltransplantation wegen einer akuten myeloischen Leukämie. Der Zustand der Patientin verschlechterte sich rasch und eine medikamentöse Therapie mit Defibrotide blieb erfolglos. Trotzdem war das progrediente Geschehen nicht an wiederholten Doppler-Ultraschall-Untersuchungen ablesbar. 19 Tage nach Stammzelltransplantation wurde als Ultima Ratio ein transjugulärer intrahepatischer portosystemischer Shunt (TIPS) gelegt. Im weiteren Verlauf besserte sich die VOD. Der Verlauf der VOD ist oft schwer vorhersagbar. Bei schwerem Verlauf ist nach Ausschöpfen der medikamentösen Therapie die TIPS-Implantation eine therapeutische Option.

Abstract

Hepatic venoocclusive disease (VOD) is a complication of allogeneic blood stem cell transplantation (SCT). Duplex ultrasound has been proposed to predict the outcome of VOD. We report here the case of a 39-year-old female patient with VOD following allogeneic SCT for AML. Repeated Doppler ultrasound examinations did not indicate a high-risk profile. However, the patient’s condition deteriorated and was refractory to medical therapy. Transjugular intrahepatic portosystemic shunting (TIPS) was performed 19 days after transplantation and VOD resolved subsequently. VOD often has an unpredictable course. Transjugular intrahepatic portosystemic shunts may prove beneficial for patients with refractory disease.

Schlüsselwörter

Venoocclusive disease - Doppler-Ultraschall - transjugulärer intrahepatischer portosystemischer Shunt

Key words

Venoocclusive disease - Doppler ultrasound - transjugular intrahepatic portosystemic shunt

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