Is the sinusoidal obstructive syndrome post-liver transplantation a pathologic entity with a multifactorial etiology?
Marín-Gómez, L.M.; Álamo-Martínez, J.é M.ía.; Suárez-Artacho, G.; Ramírez-Santos, J.é; Bernal-Bellido, C.; Barrera-Pulido, L.; Serrano-Díaz-Canedo, J.; Padillo-Ruiz, F.J.; Gómez-Bravo, M.Án.
Revista Espanola de Enfermedades Digestivas Organo Oficial de la Sociedad Espanola de Patologia Digestiva 107(4): 235-238
2015
ISSN/ISBN: 1130-0108 PMID: 25824926 Document Number: 684123
The sinusoidal obstructive syndrome is a complication typically associated with hematopoietic stem cell transplantation. This syndrome, more commonly known as veno-occlusive disease, has also been described after liver transplantation. It can have a life-threatening course. Herein, we describe the hepatic graft loss secondary to the development of a sinusoidal obstructive syndrome after a severe acute cellular rejection and toxic levels of once daily modified released tacrolimus (TAC). We discuss the role of the endotheliitis of acute rejection and toxic metabolites of some immunosuppressants such as azathioprine and TAC. Based on the current scientific evidence, we contemplate the possibility that the etiology of sinusoidal obstruction syndrome post-liver transplantation is multifactorial.