{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T16:43:19Z","timestamp":1787071399662,"version":"build-2736575974"},"reference-count":12,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,10]]},"abstract":"\n Introduction<\/jats:title>\n Hepatic veno-occlusive disease (HVOD), or sinusoidal obstruction syndrome (SOS), is a potentially liefe-threatening complication following allogeneic stem cell transplantation (allo-SCT). Historically, HVOD has affected up to 60% of allo-SCT recipients, with reported mortality rates exceeding 75% in severe cases. The approval of defibrotide in 2016 represented a major therapeutic milestone, significantly improving outcomes in high-risk patients. Despite this advancement, large-scale data on HVOD epidemiology & outcomes in allo-SCT recipients remain limited. This study aims to address these gaps & offer updated insights into its clinical impact.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n We utilized National Inpatient Sample (2016-2020) to examine factors associated with HVOD in allo-SCT recipients. Admissions for allo-SCT & HVOD were identified using International Classification of Diseases, Tenth Revision. Baseline characteristics, including patient demographics, hospital characteristics, comorbidities, complications & outcomes were compared between allo-SCT admissions with & without HVOD. Categorical variables were analyzed by\n \u03c7<\/jats:italic>\n \u00b2 test (%), & continuous variables by adjusted Wald\u2019s test (mean\u00b1SD).\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n During the study period, 200 allo-SCT admissions with HVOD were identified. HVOD admissions were younger (45.05 vs. 52.42 years;\n P<\/jats:italic>\n =0.0045) & were more likely to be female (43.72% vs. 25%;\n P<\/jats:italic>\n =0.0191). They had higher rates of acute graft-versus-host disease (GVHD) (17.5% vs. 6.47%;\n P<\/jats:italic>\n =0.0043), acute respiratory failure (32.5% vs. 8.37%;\n P<<\/jats:italic>\n 0.001), & acute kidney injury (50% vs. 20.66%;\n P<<\/jats:italic>\n 0.001). Hepatic complications, including portal hypertension (7.5% vs. 0.52%;\n P<\/jats:italic>\n <<\/jats:italic>\n 0.001), hepatic encephalopathy (12.5% vs. 0.28%;\n P<\/jats:italic>\n <0.001), cirrhosis (7.5% vs. 0.07%;\n P<\/jats:italic>\n <<\/jats:italic>\n 0.001), ascites (37.5% vs. 1.97%;\n P<\/jats:italic>\n <<\/jats:italic>\n 0.001) & spontaneous bacterial peritonitis (2.5% vs. 0.06%;\n P<\/jats:italic>\n <<\/jats:italic>\n 0.001) were also more common in this cohort. HVOD was associated with worse outcomes, including longer hospital stays (45.5 vs. 29.51 days;\n P<\/jats:italic>\n <0.001) & over 6 times higher in-hospital mortality (30% vs. 4.72%;\n P<\/jats:italic>\n <0.001). HVOD also imposed a greater economic burden, with more than double mean total hospitalization charges ($1,321,650 vs. $541,391.1;\n P<\/jats:italic>\n <0.001) & nearly triple hospitalization costs ($358,463.2 vs. $141,464.1;\n P<\/jats:italic>\n <0.001).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n This study describes HVOD-specific characteristics in allo-SCT admissions. Patients with HVOD were younger, had higher comorbidity burden, & showed increased rates of acute GVHD, multiorgan dysfunction, & hepatic complications. They also faced high in-hospital mortality, longer hospital stays, & greater healthcare costs.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/hemoncstem.hemoncstem-d-25-00043","type":"journal-article","created":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T06:00:10Z","timestamp":1770098410000},"page":"164-168","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Epidemiology and Outcomes of Hepatic Veno-Occlusive Disease after Allogeneic Hematopoietic Stem Cell Transplantation: A Descriptive Analysis of the U.S. National Inpatient Sample"],"prefix":"10.4103","volume":"18","author":[{"given":"Aditya","family":"Sharma","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Wayne State University School of Medicine, Detroit, Michigan, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarvani","family":"Surapaneni","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Trinity Health Ann Arbor Hospital, Ann Arbor, Michigan, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aditi","family":"Sharma","sequence":"additional","affiliation":[{"name":"Division of Hematology and Bone Marrow Transplant and Cellular Therapy, The University of Alabama at Birmingham Marnix E. Heersink School of Medicine, Birmingham, Alabama, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rahul","family":"Maheshwari","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Transplant Hepatology, Morehouse School of Medicine & Piedmont Transplant Institute, Atlanta, Georgia, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayman O.","family":"Soubani","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Critical Care and Sleep Medicine, Wayne State University School of Medicine, Detroit, Michigan, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,2,2]]},"reference":[{"key":"R1-20260708","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1016\/j.bbmt.2009.08.024","article-title":"Hepatic veno-occlusive disease following stem cell transplantation: incidence, clinical course, and outcome","volume":"16","author":"Coppell","year":"2010","journal-title":"Biol Blood Marrow Transplant J Am Soc Blood Marrow Transplant"},{"key":"R2-20260708","doi-asserted-by":"crossref","first-page":"2631","DOI":"10.2147\/DDDT.S112181","article-title":"Pharmacokinetic profile of defibrotide in patients with renal impairment","volume":"10","author":"Tocchetti","year":"2016","journal-title":"Drug Des Devel Ther"},{"key":"R3-20260708","doi-asserted-by":"crossref","first-page":"400","DOI":"10.1016\/j.bbmt.2015.09.024","article-title":"Hepatic veno-occlusive disease after hematopoietic stem cell transplantation: risk factors and stratification, prophylaxis, and treatment","volume":"22","author":"Dalle","year":"2016","journal-title":"Biol Blood Marrow Transplant J Am Soc Blood Marrow Transplant"},{"key":"R4-20260708","doi-asserted-by":"crossref","first-page":"1951","DOI":"10.1038\/s41409-019-0474-8","article-title":"Systematic review of defibrotide studies in the treatment of veno-occlusive disease\/sinusoidal obstruction syndrome (VOD\/SOS)","volume":"54","author":"Richardson","year":"2019","journal-title":"Bone Marrow Transplant"},{"key":"R5-20260708"},{"key":"R6-20260708","doi-asserted-by":"crossref","first-page":"166.e1","DOI":"10.1016\/j.jtct.2022.11.024","article-title":"Prognostic biomarkers for hepatic veno-occlusive disease\/sinusoidal obstruction syndrome in myeloablative allogeneic hematopoietic cell transplantation: results from the blood and marrow transplant clinical trials network 1202 study","volume":"29","author":"Putta","year":"2023","journal-title":"Transplant Cell Ther"},{"key":"R7-20260708","doi-asserted-by":"crossref","first-page":"489","DOI":"10.3389\/fimmu.2020.00489","article-title":"Diagnosis and treatment of VOD\/SOS after allogeneic hematopoietic stem cell transplantation","volume":"11","author":"Bonifazi","year":"2020","journal-title":"Front Immunol"},{"key":"R8-20260708","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1007\/s00277-004-0982-4","article-title":"Decreased incidence of hepatic veno-occlusive disease and fewer hemostatic derangements associated with intravenous busulfan vs oral busulfan in adults conditioned with busulfan + cyclophosphamide for allogeneic bone marrow transplantation","volume":"84","author":"Lee","year":"2005","journal-title":"Ann Hematol"},{"key":"R9-20260708","doi-asserted-by":"crossref","first-page":"1128","DOI":"10.1182\/bloodadvances.2023011233","article-title":"Incidence and risk factors of early onset VOD\/SOS differ in younger vs older adults after stem cell transplantation","volume":"8","author":"Marcoux","year":"2024","journal-title":"Blood Adv"},{"key":"R10-20260708","doi-asserted-by":"crossref","first-page":"1635","DOI":"10.1038\/s41409-021-01233-w","article-title":"Hepatic veno-occlusive disease\/sinusoidal obstruction syndrome after hematopoietic stem cell transplantation for thalassemia major: incidence, management, and outcome","volume":"56","author":"Lai","year":"2021","journal-title":"Bone Marrow Transplant"},{"key":"R11-20260708","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1111\/j.1365-2036.2006.02742.x","article-title":"Review article: updates in the pathogenesis and therapy of hepatic sinusoidal obstruction syndrome","volume":"23","author":"Helmy","year":"2006","journal-title":"Aliment Pharmacol Ther"},{"key":"R12-20260708","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1016\/j.bbmt.2018.09.027","article-title":"Sinusoidal obstruction syndrome\/veno-occlusive disease after autologous or allogeneic hematopoietic stem cell transplantation in children: a retrospective study of the Italian Hematology-Oncology Association-Hematopoietic Stem Cell Transplantation Group","volume":"25","author":"Faraci","year":"2019","journal-title":"Biol Blood Marrow Transplant J Am Soc Blood Marrow Transplant"}],"container-title":["Hematology\/Oncology and Stem Cell Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/hemoncstem.HEMONCSTEM-D-25-00043","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:45:36Z","timestamp":1787067936000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/hemoncstem.HEMONCSTEM-D-25-00043"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10]]},"references-count":12,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.4103\/hemoncstem.hemoncstem-d-25-00043","relation":{},"ISSN":["1658-3876","2589-0646"],"issn-type":[{"value":"1658-3876","type":"print"},{"value":"2589-0646","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10]]},"assertion":[{"value":"2025-10-15","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-22","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}