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Spectral Doppler Ultrasound Can Help Diagnose Children With Hepatic Sinusoidal Obstructive Syndrome After Hematopoietic Stem Cell Transplantation. | LitMetric

AI Article Synopsis

  • Hepatic sinusoidal obstruction syndrome (SOS) is a serious complication that can occur after hematopoietic stem cell transplantation (HSCT), with current guidelines indicating that imaging is mainly for confirming the diagnosis rather than early detection.
  • A study was conducted on pediatric HSCT patients to identify ultrasound characteristics that could predict the onset of SOS, analyzing data from 333 patients, of which 140 had relevant ultrasound findings.
  • Key findings show that increased peak systolic velocity in certain arteries and changes in ascites severity are strong predictors for developing SOS, with notable impacts on patient outcomes, including mortality.

Article Abstract

Background: Hepatic sinusoidal obstruction syndrome (SOS) is a potentially fatal complication after hematopoietic stem cell transplantation (HSCT). Current clinical guidelines state that spectral Doppler changes occur late in the disease, and imaging is only useful for confirming SOS diagnosis.

Objective: Our primary objective was to examine abdominal ultrasound variables as predictors of development of SOS in pediatric HSCT patients.

Materials And Methods: A single-center cohort retrospective study was conducted on patients aged 0 to 21 years who underwent HSCT between September 2001 and May 2017 at our institution. Patients were excluded if they did not have abdominal ultrasounds after HSCT. Clinical, demographic, grayscale, and spectral Doppler liver ultrasound findings were evaluated. We modeled the odds of SOS diagnosis within 100 days after HSCT as a function of each of the 15 ultrasound variables.

Results: A total of 333 patients received an HSCT. One hundred forty subjects had ultrasound data available. Thirty-two patients developed SOS, and 9 of these patients died. Sinusoidal obstruction syndrome odds more than double per 1-SD increase in peak systolic velocity in common hepatic artery or left hepatic artery and more than triple per 1-SD decrease in main portal vein velocity or change in ascites severity. Several ultrasound variables were statistically significant predictors in the Cox models for time to SOS diagnosis.

Conclusion: Several ultrasound variables can be used as predictors for a patient's risk of developing SOS. The strongest predictors are ascites severity, main portal vein velocity, common hepatic artery peak systolic velocity, and left hepatic artery peak systolic velocity.

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Source
http://dx.doi.org/10.1097/RUQ.0000000000000441DOI Listing

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