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In China, this disease is often associated with the oral intake of plants that contain pyrrolidine alkaloids. The existing guidelines are limited to HSOS associated with hematopoietic stem cell transplantation in Western countries. The Hepatobiliary Diseases Committee of the Chinese Society of Gastroenterology convened an expert consensus conference on the diagnosis and treatment of PA\u2013HSOS to evaluate current research in China and abroad. The \u201cNanjing criteria\u201d developed by the committee to diagnose PA\u2013HSOS include a confirmed history of PA\u2010containing plant use and (i) abdominal distention and\/or pain in the hepatic region, hepatomegaly, and ascites; (ii) elevation of serum total bilirubin or abnormal laboratory liver tests; (iii) evidence on enhanced computed tomography or magnetic resonance imaging; or (iv) pathological evidence that rules out other known causes of liver injury. Supportive symptomatic treatment, anticoagulant therapy, and placement of a transjugular intrahepatic portosystemic shunt for patients who do not respond to medical treatment are effective for the treatment of PA\u2013HSOS. The benefits of glucocorticoids and prostaglandin E1 in PA\u2013HSOS are not clear.<\/jats:p>","DOI":"10.1111\/jgh.14612","type":"journal-article","created":{"date-parts":[[2019,1,24]],"date-time":"2019-01-24T05:47:22Z","timestamp":1548308842000},"page":"634-642","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":106,"title":["Expert consensus on the clinical management of pyrrolizidine alkaloid\u2010induced hepatic sinusoidal obstruction syndrome"],"prefix":"10.1111","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0649-4457","authenticated-orcid":false,"given":"Yuzheng","family":"Zhuge","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Nanjing Drum Tower Hospital Affiliated to Nanjing University Medical School  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yulan","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Peking University People's Hospital  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weifen","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Changzheng Hospital of the Second Military Medical University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoping","family":"Zou","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Nanjing Drum Tower Hospital Affiliated to Nanjing University Medical School  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianming","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology The First Affiliated Hospital of Anhui University  Anhui China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiyao","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Zhongshan Hospital of Fudan University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Chinese Society of Gastroenterology Committee of Hepatobiliary Disease","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,2,21]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/1751-2980.12112"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1751-2980.2011.00552.x"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2010.07.031"},{"key":"e_1_2_10_5_1","first-page":"577","article-title":"Raise the recognition of hepatic veno\u2010occlusive disease induced by chrysanthemum\u2010like groundsel","volume":"14","author":"Xu ZM","year":"2009","journal-title":"Chin. 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