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Nursing role in the assessment and care of hepatic sinusoidal obstruction syndrome patients: a consensus paper by the “Gruppo Italiano Trapianto di Midollo Osseo”

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Abstract

Purpose

Sinusoidal obstruction syndrome (SOS) is one of the most serious complications post haematopoietic stem cell transplantation (HSCT). The diagnosis of SOS is clinical, but nurses should be involved in the pre-transplant risk assessment period and play a crucial role in the early detection of signs and symptoms during and after hospitalization. The aim of this work is to achieve a consensus on nurses’ behaviour in caring for SOS.

Methods

On behalf of the Italian Group for Bone and Marrow Transplantation (GITMO), a promoter committee was established to put in place a consensus conference approach. A multidisciplinary group of GITMO together with four nurses, three haematology physicians and one patient representative acted as jury, who reviewed the reports and wrote recommendations and suggestions. Recommendations gaining 100% of consensus were considered ‘Golden Points of Care’; if a consensus was achieved by ≥ 75% of the jury’s members, those recommendations were defined as ‘Good Practices’.

Results

Eighteen papers written by nurses as first authors have been identified. Golden Points of Care and Good Practices were worked out for the following topics: nurses’ role in general, nurses’ role in pre-transplant assessment, pre-transplant risk assessment and risk stratification, baseline monitoring, suspected mild or moderate SOS, suspected severe or very severe SOS and late-onset cases.

Conclusion

SOS is relatively rare; therefore, a holistic approach to the patients’ needs considering nursing role as essential may result in better care outcomes.

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Authors and Affiliations

  1. Haematology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy

    Stefano Botti, Cristiana Caffarri, Janini Silva Cardoso, Stefano Luminari & Francesco Merli

  2. Bone Marrow Transplant Unit Denis Burkitt, St. James’s Hospital, Dublin, Ireland

    Iris Agreiter

  3. Bone Marrow Transplant Unit, Istituto Oncologico Svizzera Italiana, Bellinzona, Switzerland

    Laura Orlando

  4. Haematology Unit, Federico II University Hospital of Naples, Naples, Italy

    Gianpaolo Gargiulo

  5. Institute of Haematology “Seràgnoli”, University Hospital S. Orsola-Malpighi, Bologna, Italy

    Francesca Bonifazi

  6. Bone Marrow Transplant Unit, Fondazione IRCCS Ca’ Grande Ospedale Maggiore Policlinico and University of Milan, Milan, Italy

    Marina Marialuisa Banfi

  7. Department of Haematology, Guglielmo da Saliceto Hospital Piacenza, Piacenza, Italy

    Lorella Cappucciati

  8. Paediatric Haematology/Oncology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy

    Valentina De Cecco & Marco Zecca

  9. Paediatric Haematology/Oncology Department, IRCCS G. Gaslini, Genoa, Italy

    Giuseppe Marco Deiana

  10. Haematology and Bone Marrow Transplantation Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy

    Marta Gavezzotti

  11. Division of Haemato-oncology, European Institute of Oncology Milan, Milan, Italy

    Antonio Magarò

  12. Department of Pediatric Oncology, Neuro-Oncology Unit, Meyer Children’s University Hospital Florence, Florence, Italy

    Maria Giovanna Netti

  13. Department of Haematology, Regina Elena National Cancer Institute, Rome, Italy

    Adriana Concetta Pignatelli

  14. Paediatric Haemato-oncology and BMT Department, Azienda Ospedaliero, Universitaria S. Orsola Malpighi, Bologna, Italy

    Elena Rostagno

  15. Adult BMT Unit, ASST Spedali Civili Brescia, Brescia, Italy

    Emanuela Samarani & Concetta Maria Valente

  16. Stem Cell Transplant Unit, Department of Hematology, Tor Vergata “University Hospital” Rome, Rome, Italy

    Sonia Soave

  17. Health Profession Direction, Nursing Course University of Padova, Padua, Italy

    Alessio Vedovetto

  18. Health Professions Direction, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy

    Monica Guberti

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  1. Stefano Botti
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  2. Iris Agreiter
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  3. Laura Orlando
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Correspondence to Stefano Botti.

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Botti, S., Agreiter, I., Orlando, L. et al. Nursing role in the assessment and care of hepatic sinusoidal obstruction syndrome patients: a consensus paper by the “Gruppo Italiano Trapianto di Midollo Osseo”. Support Care Cancer 28, 5125–5137 (2020). https://doi.org/10.1007/s00520-020-05353-9

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