Severe liver
injury can result from hepatic veno-occlusive disease (VOD). Elevated
levels of bilirubin, hepatomegaly and fluid retention are clinical
hallmarks of this condition. There is now a greater appreciation
of the generalized cellular injury and obstruction in hepatic vein
sinuses, and hepatic VOD has lately been referred to as sinusoidal
obstruction syndrome (SOS). Severe cases of SOS are associated with a
high mortality rate. Anticoagulants or
defibrotide may be effective in reducing the severity of VOD but may
also increase bleeding complications. Ursodiol has been shown to help
prevent VOD, presumably by facilitating the flow of bile.
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