TREATMENT OF VENOOCCLUSIVE DISEASE OF THE LIVER WITH BOLUS TISSUE-PLASMINOGEN ACTIVATOR AND CONTINUOUS-INFUSION ANTITHROMBIN-III CONCENTRATE

Veno-occlusive disease (VOD) of the liver is a common complication of BMT and is accompanied by reduced levels of natural anticoagulants and by multi-organ dysfunction, We describe two cases of clinical VOD dev eloping after autologous BMT and accompanied by ultrasonographic featu res of reversed portal venous flow, In both cases the patients had dec reased levels of antithrombin (AT). Once the diagnosis of VOD was made , these patients were treated with tissue plasminogen activator (tPA) and continuous infusion AT. Each patient had radiographic and clinical resolution of VOD with the therapy. This novel treatment appears to h ave reversed the course of VOD without the increased risk of bleeding seen in the use of heparin therapy.