Hepatic veno-occlusive disease (VOD) is a major cause of morbidity and mortality following high dose cytotoxic therapy for stem cell transplantation (SCT). Pre-existing liver damage, SCT-related therapy, and genetic polymorphisms all appear to increase the risk of developing VOD. Studies of biological markers during SCT suggest that cytokines, haemostasis, and hepatic drug metabolism via the glutathione pathway are all involved in the pathogenesis of VOD. Until recently, treatment options were limited and experimental therapies directed at the pathogenesis of the disease were mostly unsuccessful. However, Defibrotide, a relatively new agent that has modulatory effects on vascular endothelium, cytokine release, and haemostasis, has been used with some success in the management and prophylaxis of VOD. In the future, a better understanding of genetic polymorphisms and biological markers which may be important in the pathogenesis of VOD, may enable us to predict which patients are most likely to be affected.

中文翻译：

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静脉闭塞性疾病：细胞因子，遗传学和止血。

肝静脉闭塞性疾病（VOD）是干细胞移植（SCT）的高剂量细胞毒疗法后发病和死亡的主要原因。既往肝损伤，SCT相关疗法和遗传多态性似乎都增加了发生VOD的风险。SCT期间生物学标记的研究表明，通过谷胱甘肽途径的细胞因子，止血和肝药物代谢均与VOD的发病机理有关。直到最近，治疗选择还很有限，针对该疾病发病机理的实验疗法大多还没有成功。然而，去纤维蛋白多聚糖（一种对血管内皮，细胞因子释放和止血具有调节作用的相对较新的药物）已被用于VOD的管理和预防。在将来，