Avoiding hepatic veno-occlusive disease: what do we know and where are we going?

Hepatic venocclusive disease (VOD) is a common toxicity associated with mye loablative chemotherapy or chemoradiotherapy used to prepare patients for s tem cell transplantation. A sizable proportion of patients who develop VOD die, It is clear that injury to endothelial cells and hepatocytes in zone 3 of the liver acinus is the initial event in the pathogenesis of VOD, What are less clear are the mechanisms of injury and whether this knowledge can be exploited. This manuscript M;ill briefly review some recent data and dis cuss how that information has influenced clinical practice.