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Gallbladder wall oedema and ascites are independent predictors of progression to hepatic veno-occlusive disease for children with hematopoietic stem cell transplantation

  • Paediatric
  • Published:
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Abstract

Objectives

To evaluate the predictive value of ultrasonography in children with clinically suspicious hepatic veno-occlusive disease (VOD) after hematopoietic stem cell transplantation (HSCT).

Methods

Among 216 children who underwent HSCT, 70 also underwent colour Doppler ultrasonography. Of these, 59 had only one sign/symptom, which did not fulfil the diagnostic criteria (clinical suspicion of VOD) at that time. VOD was confirmed in 20 patients (VOD group), while 39 had other conditions (non-VOD group). The following findings were reviewed and compared between groups: left portal vein (peak velocity, direction), left hepatic artery (peak-systolic/end-diastolic velocities, resistive index), middle hepatic vein (peak velocity, phasicity), hepatomegaly, splenomegaly, gallbladder wall thickness, and ascites.

Results

The VOD group showed significantly higher reversed flow in portal vein (P = 0.011), peak systolic velocity of left hepatic artery (P = 0.028), monophasicity of middle hepatic vein (P = 0.015), hepatomegaly (P = 0.001), gallbladder wall thickness (P < 0.001), and ascites (P < 0.001). Multivariate regression revealed that gallbladder wall thickness and ascites (odds ratio = 35.370, 56.393) were associated with VOD.

Conclusions

The presence of reversed flow in portal vein, increased peak systolic velocity of hepatic artery, monophasicity of hepatic vein, hepatomegaly, gallbladder wall thickness, and ascites were significantly associated with progression to VOD in children with clinically suspicious VOD after HSCT.

Key Points

• Ultrasonography with Doppler can help predict progression to VOD.

• Gallbladder wall oedema and ascites are the independent predictors of progression to VOD.

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Abbreviations

VOD:

Hepatic veno-occlusive disease

HSCT:

Hematopoietic stem cell transplantation

RI:

Resistive index

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Authors and Affiliations

  1. Department of Radiology, Seoul National University Children’s Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Korea

    Ji Eun Park, Young Hun Choi, Jung-Eun Cheon, Woo Sun Kim, In-One Kim, Young Jin Ryu & Yu Jin Kim

  2. Department of Radiology, Kyung Hee University Hospital, Graduate School, Kyung Hee University, Seoul, Korea

    Ji Eun Park

  3. Department of Radiology, Seoul National University College of Medicine, Seoul, Korea

    Jung-Eun Cheon, Woo Sun Kim & In-One Kim

  4. Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Korea

    Young Hun Choi, Jung-Eun Cheon, Woo Sun Kim & In-One Kim

  5. Department of Pediatrics, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea

    Che Ry Hong & Hyoung Jin Kang

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  1. Ji Eun Park
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Correspondence to Young Hun Choi.

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The scientific guarantor of this publication is Young Hun Choi.

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The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

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The authors state that this work has not received any funding.

Statistics and biometry

No complex statistical methods were necessary for this paper.

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This retrospective study was approved by the institutional review board, which waived the requirement for informed consent.

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Institutional Review Board approval was obtained.

Methodology

• prospective

• observational

• performed at one institution

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Park, J.E., Choi, Y.H., Cheon, JE. et al. Gallbladder wall oedema and ascites are independent predictors of progression to hepatic veno-occlusive disease for children with hematopoietic stem cell transplantation. Eur Radiol 28, 2291–2298 (2018). https://doi.org/10.1007/s00330-017-5137-9

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  • DOI: https://doi.org/10.1007/s00330-017-5137-9

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