{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T01:32:59Z","timestamp":1780450379982,"version":"3.54.1"},"reference-count":20,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,1,8]],"date-time":"2025-01-08T00:00:00Z","timestamp":1736294400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Transplantation"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Veno\u2010occlusive disease (VOD) and transplant\u2010associated thrombotic microangiopathy (TA\u2010TMA) remain a diagnostic and therapeutic challenge for patients undergoing hematopoietic stem cell transplant (HSCT). Both VOD and TA\u2010TMA share an underlying etiology of microvascular endothelial damage. Potential under\u2010recognition of TA\u2010TMA in the context of VOD leaves HSCT recipients vulnerable to additional endothelial damage, and risk of end\u2010organ failure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A cohort of 44 pediatric HSCT recipients diagnosed with VOD between 2010and 2019 were retrospectively evaluated for the development of TA\u2010TMA within 1\u2009week before and 2\u2009months after VOD diagnosis. Patients were classified into three categories: sole diagnosis of VOD (VOD), concurrent clinical diagnosis of TA\u2010TMA during the VOD course (VOD+TA\u2010TMA), and patients with VOD who on retrospective review satisfied criteria for diagnosis of TA\u2010TMA (VOD+rTA\u2010TMA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 42 patients were evaluated and 50% of the patients were diagnosed clinically with TA\u2010TMA (5) or where retrospectively identified to have TA\u2010TMA (16). There was no difference in the severity of the course of VOD between the three groups based on need for intubation, dialysis, and pediatric intensive care unit (PICU) care. Patients in the VOD only group had the highest survival at 1\u2009year (66.7%, <jats:italic>n<\/jats:italic>\u2009=\u200914) compared with patients in the VOD+TA\u2010TMA group (60%, <jats:italic>n<\/jats:italic>\u2009=\u20093) and VOD+rTA\u2010TMA group (62.5%, <jats:italic>n<\/jats:italic>\u2009=\u200910), <jats:italic>p<\/jats:italic>\u2009=\u20090.9582.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Better understanding of the association between these two endotheliopathies is essential to improve diagnosis, treatment, and prevention of potentially fatal adverse outcomes in transplant recipients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/petr.70003","type":"journal-article","created":{"date-parts":[[2025,1,8]],"date-time":"2025-01-08T09:59:21Z","timestamp":1736330361000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["A Second Look: Retrospective Identification of Thrombotic Microangiopathy in Pediatric Stem Cell Transplant Patients With Veno\u2010Occlusive Disease"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3851-1979","authenticated-orcid":false,"given":"Mahvish Q.","family":"Rahim","sequence":"first","affiliation":[{"name":"Pediatric Hematology Oncology and Stem Cell Transplant, Department of Pediatrics Indiana University School of Medicine  Indianapolis Indiana USA"},{"name":"Riley Hospital for Children at Indiana University Health  Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cydney","family":"Nichols","sequence":"additional","affiliation":[{"name":"Pediatric Hematology Oncology and Stem Cell Transplant, Department of Pediatrics Indiana University School of Medicine  Indianapolis Indiana USA"},{"name":"Riley Hospital for Children at Indiana University Health  Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra","family":"Althouse","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Health Data Science Indiana University School of Medicine  Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"April L.","family":"Rahrig","sequence":"additional","affiliation":[{"name":"Pediatric Hematology Oncology and Stem Cell Transplant, Department of Pediatrics Indiana University School of Medicine  Indianapolis Indiana USA"},{"name":"Riley Hospital for Children at Indiana University Health  Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,1,8]]},"reference":[{"issue":"5","key":"e_1_2_8_2_1","first-page":"516","article-title":"Thrombotic Complications After Hematopoietic Stem Cell Transplantation","volume":"58","author":"Nomura S.","year":"2017","journal-title":"Rinsh\u014d 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