Interventions for prophylaxis of hepatic veno-occlusive disease in people undergoing haematopoietic stem cell transplantation.

Study answer

What this study found

Overall, ursodeoxycholic acid showed the clearest benefit and may reduce hepatic veno-occlusive disease and mortality after hematopoietic stem cell transplantation, although the evidence was low or very low quality. Across four trials, ursodeoxycholic acid reduced hepatic veno-occlusive disease incidence, RR 0.60 (0.40 to 0.88), all-cause mortality, RR 0.70 (0.50 to 0.99), and mortality attributable to veno-occlusive disease, RR 0.27 (0.09 to 0.87); overall survival was not clearly improved, HR 0.83 (0.59 to 1.18). Defibrotide showed a possible reduction in veno-occlusive disease incidence,…

Study & population

Systematic review and meta-analysis of randomized trials in people undergoing hematopoietic stem cell transplantation, including both autologous and allogeneic transplants and both adults and children.

Intervention

This systematic review evaluated prophylactic regimens used around hematopoietic stem cell transplantation, most notably ursodeoxycholic acid, heparin or low molecular weight heparin, defibrotide, glutamine, antithrombin III, prostaglandin E1, and fresh frozen plasma.

Key limitation

The evidence base was low to very low quality, with many small trials, wide confidence intervals, and heterogeneous prophylactic regimens, doses, and comparators.

View full study detailsView sourceOpen PDF

Original abstract