{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T15:29:44Z","timestamp":1770823784087,"version":"3.50.1"},"reference-count":38,"publisher":"BMJ","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Gut"],"published-print":{"date-parts":[[1982,6]]},"abstract":"<jats:p>Liver dysfunction occurs after bone marrow transplantation but the relative importance of graft versus host disease and other factors, such as infection, radiation, and drugs, has not been clearly established. We have studied liver status before and after bone marrow transplantation in 43 consecutive patients and have related this to survival and factors that are recognised to cause liver injury. Minor abnormalities of liver tests occurred in 21% of patients before grafting but this did not influence survival or the development of liver disease after transplantation. During the first 50 days after grafting, 83% of patients had abnormal liver tests which were more severe in patients who subsequently died. Alanine transaminase was significantly higher in non-survivors and appeared to predict survival early after transplantation. Only non-survivors developed clinical signs of liver disease. Severe liver disease was always associated with graft versus host disease and atypia of the small bile ducts was the most useful histological marker of hepatic involvement with this disease. Two of the patients with hepatic graft versus host disease also has hepatic veno-occlusive disease and three fatalities had opportunistic infection of the liver, although, in the latter, death was not due primarily to liver dysfunction. Previous hepatitis and androgen therapy could not be implicated as important causes of hepatic damage but chemotherapy for acute leukaemia and conditioning regimens for bone marrow transplantation appear to be the most important factors in the development of hepatic veno-occlusive disease.<\/jats:p>","DOI":"10.1136\/gut.23.6.465","type":"journal-article","created":{"date-parts":[[2007,9,18]],"date-time":"2007-09-18T17:41:31Z","timestamp":1190137291000},"page":"465-474","source":"Crossref","is-referenced-by-count":52,"title":["Liver disease after bone marrow transplantation."],"prefix":"10.1136","volume":"23","author":[{"given":"M J","family":"Farthing","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M L","family":"Clark","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J P","family":"Sloane","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R L","family":"Powles","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T J","family":"McElwain","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[1982,6,1]]},"reference":[{"key":"ref_1","first-page":"179","volume":"63","author":"Kruger, G.R.F.; Berard, C.W.; DeLellis, R.A.","year":"1971","unstructured":"Kruger GRF, Berard CW, DeLellis RA et al. Graftversus-host disease. Am J Pathol 1971; 63: 179-201.","journal-title":"Graftversus-host disease. Am J Pathol"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"895","DOI":"10.1056\/NEJM197504242921706","article-title":"Bone marrow transplantation (second of two parts)","volume":"292","author":"Thomas, E.D.; Storb, R.; Clift, R.A.","year":"1975","unstructured":"Thomas ED, Storb R, Clift RA et al. Bone marrow transplantation (second of two parts). N Engl J Med 1975; 292: 895-902.","journal-title":"N Engl J Med"},{"key":"ref_3","first-page":"675","article-title":"The pathology of graft-versus-host reaction (GVHR) in adults receiving bone marrow transplants","volume-title":"Transplant Proc 1976","volume":"8","author":"Woodruff, J.M.; Hansen, J.A.; Good, R.A.","unstructured":"Woodruff JM, Hansen JA, Good RA et al. The pathology of graft-versus-host reaction (GVHR) in adults receiving bone marrow transplants. 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Marrow transplantation for acute nonlymphoblastic leukaemia in first remission. N Engl J Med 1979; 301: 597-9.","journal-title":"N Engl J Med"},{"key":"ref_6","first-page":"369","article-title":"Pathology of the liver with bone marrow transplantation. Effects of busulfan, carmustine, acute graft-versus-host disease and cytomegalovirus infection","volume":"99","author":"Beschorner, W.E.; Pino, J.; Boitnott, J.K.; Tutschka, P.J.; Santos, G.","year":"1980","unstructured":"Beschorner WE, Pino J, Boitnott JK, Tutschka PJ, Santos G. Pathology of the liver with bone marrow transplantation. Effects of busulfan, carmustine, acute graft-versus-host disease and cytomegalovirus infection. 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Dig Dis Sci 1979; 24: 785-96.","journal-title":"Dig Dis Sci"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1047","DOI":"10.1016\/S0140-6736(80)91497-X","article-title":"Bone marrow transplantation in acute myelogenous leukaemia","volume":"1","author":"Powles, R.L.; Clink, H.M.; Bandini, G.","year":"1980","unstructured":"Powles RL, Clink HM, Bandini G et al. Bone marrow transplantation in acute myelogenous leukaemia. Lancet 1980; 1: 1047-50.","journal-title":"Lancet"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"610","DOI":"10.7326\/0003-4819-81-5-610","article-title":"Peliosis hepatitis associated with androgenic anabolic steroid therapy. A severe form of hepatic injury","volume":"81","author":"Bagheri, S.A.; Boyer, J.L.","year":"1974","unstructured":"Bagheri SA, Boyer JL. Peliosis hepatitis associated with androgenic anabolic steroid therapy. A severe form of hepatic injury. 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Br Med J 1970; 2: 588.","journal-title":"Br Med J"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"878","DOI":"10.1001\/archsurg.1968.01330240024006","article-title":"Radiation hepatitis","volume":"96","author":"Lansing, A.M.; Davis, W.M.; Brizel, H.E.","year":"1968","unstructured":"Lansing AM, Davis WM, Brizel HE. Radiation hepatitis. Arch Surg 1968; 96: 878-82.","journal-title":"Arch Surg"},{"key":"ref_24","first-page":"21","article-title":"Human radiation hepatitis","volume":"96","author":"Lewin, K.; Millis, R.R.","year":"1973","unstructured":"Lewin K, Millis RR. Human radiation hepatitis. Arch Pathol 1973; 96: 21-6.","journal-title":"Arch Pathol"},{"key":"ref_25","first-page":"597","article-title":"The human liver after radiation injury","volume":"48","author":"Reed, G.B.; Cox, A.J.","year":"1966","unstructured":"Reed GB, Cox AJ. The human liver after radiation injury. 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AJR 1971; 111: 16573.","journal-title":"AJR"},{"key":"ref_28","first-page":"367","article-title":"Histopathology of graft versus host reaction (GVHR) in human recipients of marrow from HL-A matched","volume-title":"sibling donors. Transplant Proc","volume":"6","author":"Lerner, K.G.; Kao, G.F.; Storb, R.","year":"1974","unstructured":"Lerner KG, Kao GF, Storb R et al. Histopathology of graft versus host reaction (GVHR) in human recipients of marrow from HL-A matched sibling donors. Transplant Proc 1974; 6: 367-71."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1097\/00007890-197808000-00009","article-title":"Histopathology of acute graft-versus-host disease in the dog","volume":"26","author":"Sale, G.E.; Storb, R.; Kolb, H.","year":"1978","unstructured":"Sale GE, Storb R, Kolb H. Histopathology of acute graft-versus-host disease in the dog. Transplantation 1978; 26: 103-6.","journal-title":"Transplantation"},{"key":"ref_30","article-title":"Radiation chimeras","author":"DW, Van Bekkum; MJ, De Vries","year":"1967","unstructured":"Van Bekkum DW, De Vries MJ. Radiation chimeras. New York: Academic Press, 1967."},{"key":"ref_31","first-page":"291","article-title":"Pathology of bone marrow transplantation","volume":"9","author":"Slavin, R.E.; Woodruff, J.M.","year":"1974","unstructured":"Slavin RE, Woodruff JM. Pathology of bone marrow transplantation. Pathol Ann 1974; 9: 291-344.","journal-title":"Pathol Ann"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"158","DOI":"10.7326\/0003-4819-90-2-158","article-title":"Veno-occlusive disease of the liver after allogeneic bone marrow transplantation","volume":"90","author":"Berk, P.D.; Popper, H.; Kruger, G.R.F.; Decter, J.; Herzig, G.; Graw, R.G.","year":"1979","unstructured":"Berk PD, Popper H, Kruger GRF, Decter J, Herzig G, Graw RG. Veno-occlusive disease of the liver after allogeneic bone marrow transplantation. Ann Intern Med 1979; 90: 158-64.","journal-title":"Ann Intern Med"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1136\/bmj.1.5750.625","article-title":"Liver damage due to methotrexate in patients with psoriasis","volume":"1","author":"Dahl, M.G.C.; Gregory, M.M.; Scheuer, P.J.","year":"1971","unstructured":"Dahl MGC, Gregory MM, Scheuer PJ. Liver damage due to methotrexate in patients with psoriasis. Br Med J 1971; 1: 625-30.","journal-title":"Br Med J"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"654","DOI":"10.1136\/bmj.1.5801.654","article-title":"Methotrexate hepatotoxicity in psoriasis - comparison of different dose regimens","volume":"1","author":"Dahl, M.G.C.; Gregory, M.M.; Scheuer, P.J.","year":"1972","unstructured":"Dahl MGC, Gregory MM, Scheuer PJ. Methotrexate hepatotoxicity in psoriasis - comparison of different dose regimens. Br Med J 1972; 1: 654.","journal-title":"Br Med J"},{"key":"ref_35","first-page":"1324","article-title":"Cyclosporin A in patients receiving renal allografts from cadaver donors","volume":"2","author":"Calne, R.Y.; Thiru, S.; McMaster, P.","year":"1978","unstructured":"Calne RY, Thiru S, McMaster P et al. Cyclosporin A in patients receiving renal allografts from cadaver donors. Lancet 1978; 2: 1324-7.","journal-title":"Lancet"},{"key":"ref_36","first-page":"860","article-title":"Cyclosporin A: Preliminary observations in dogs with pancreatic duodenal allografts and patients with cadaveric","volume-title":"renal transplants. Transplant Proc 1979; 11","author":"JG, Calne R.Y.White; BD, Pentlow","unstructured":"Calne RY. White JG, Pentlow BD et al. Cyclosporin A: Preliminary observations in dogs with pancreatic duodenal allografts and patients with cadaveric renal transplants. Transplant Proc 1979; 11: 860-4."},{"key":"ref_37","first-page":"5","article-title":"Fatal veno-occlusive disease of the liver after chemotherapy, whole body irradiation and bone marrow transplantation for refractory acute leukaemia","volume":"55","author":"Jacobs, P.; Miller, J.L.; Uys, C.J.; Dietrich, B.E.","year":"1979","unstructured":"Jacobs P, Miller JL, Uys CJ, Dietrich BE. Fatal veno-occlusive disease of the liver after chemotherapy, whole body irradiation and bone marrow transplantation for refractory acute leukaemia. 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