Veno-occlusive disease (VOD)

Veno-occlusive disease (VOD), which is also called sinusoidal obstruction syndrome (SOS), happens when the small blood vessels that lead into the liver and are inside the liver become blocked. VOD is caused by high doses of chemotherapy and radiation therapy given before an allogeneic stem cell transplant. It develops in the first few weeks after a stem cell transplant and can be mild to severe.

Symptoms of VOD include:

  • jaundice
  • liver tenderness (under the ribs on the right side of the body)
  • ascites
  • sudden weight gain
  • liver enlargement
  • liver failure

Preventing and managing VOD

The drug defibrotide (Prociclide) may be used to prevent or treat VOD.

Most people have mild to moderate VOD. Some people recover without treatment within a few weeks or after they get more of the drugs given to suppress the immune system.

Sometimes VOD is severe and can lead to liver failure. If this happens, a liver transplant may be needed.

Expert review and references

  • American Cancer Society . Stem Cell Transplant for Cancer . 2016 :
  • Beers MH, Berkow R (eds.) . Merck Manual Professional Version: Veno-Occlusive Disease . 2016 :
  • British Columbia Ministry of Health . HealthLink BC: Allogeneic Stem Cell Transplant . 2016 :
  • Zack E. Principles and techniques of bone marrow transplantation. Yarbro CH, Wujcki D, Holmes GB, (eds.). Cancer Nursing: Principles and Practice . 8th ed. Burlington, MA: Jones and Barlett Learning; 2018: 17:555–590.