ORTHOTOPIC LIVER-TRANSPLANTATION FOR VENOOCCLUSIVE DISEASE COMPLICATING AUTOLOGOUS BONE-MARROW TRANSPLANTATION

Background. Veno occlusive disease of the liver is a serious and often life-threatening complication after bone marrow transplantation. Alth ough risk factors for the development of veno-occlusive disease have b een postulated, there is no precise method for accurately identifying those patients who are at risk and for whom early intervention and tre atment would have maximum potential benefit. Liver transplantation has been advocated as a treatment for veno-occlusive disease in selected patients. Methods. In this report, we describe a patient who underwent liver transplantation for life-threatening veno-occlusive disease aft er autologous bone marrow transplantation for acute lymphoblastic leuk emia. Results. Liver engraftment was achieved, but the patient develop ed Pneumocystis pneumonia, which failed to respond to pentamidine. The patient died 6 months after liver transplantation. Conclusions. While acknowledging the limited experience of orthotropic liver transplanta tion in this patient population, we suggest its consideration as a fea sible, potentially beneficial treatment option in patients with severe veno-occlusive disease after bone marrow transplantation.