TIPS for veno-occlusive disease following stem cell transplantation.

Hepatic veno-occlusive disease (VOD) is a complication of allogeneic blood stem cell transplantation (SCT). Duplex ultrasound has been proposed to predict the outcome of VOD. We report here the case of a 39-year-old female patient with VOD following allogeneic SCT for AML. Repeated Doppler ultrasound examinations did not indicate a high-risk profile. However, the patient's condition deteriorated and was refractory to medical therapy. Transjugular intrahepatic portosystemic shunting (TIPS) was performed 19 days after transplantation and VOD resolved subsequently. VOD often has an unpredictable course. Transjugular intrahepatic portosystemic shunts may prove beneficial for patients with refractory disease.