Gastrointestinal and hepatic complications are common in the hematopoietic stem cell transplant (HSCT) patient. The agents used in the conditioning regimen induce direct disruption of the intestinal barrier as well as indirect damage from cytokine release and generalized inflammatory state. These events lead to permeation of bacteria and endotoxins through the bowel wall, with subsequent organ damage and increased risk for infections. Similarly, HSCT conditioning can directly affect the hepatic parenchyma or hepatic sinusoids. The immunosuppressed state of the HSCT patient also increases the risk for opportunistic infections of the gastrointestinal tract and liver.
KeywordsHepatitis Pancreatitis Radionuclide Diarrhea Bilirubin
- Crouch, M., Restino, M., Cruz, J., Perry, J., Hurd, D. (1996). Octreotide acetate in refractory bone marrow transplant-associated diarrhea. Ann Pharmacothera, 30(4):331–336.Google Scholar
- Firpi, R., Nelson, D. (2006). Viral hepatitis: Manifestations and management strategy. Hematology Am Soc Hematol Educ Program, 375–380.Google Scholar
- Geller, R., Gilmore, C., Dix, S., Lin, L., Topping, D., Davidson, T., et al. (1995). Randomized trial of loperimide versus dose escalation of octreotide acetate for chemotherapy-induced diarrhea in bone marrow transplant and leukemia patients. Am J Hematol, 50(3):167–172.CrossRefPubMedGoogle Scholar
- Ippoliti, C., Champlin, R., Bugazia, N., Przepiorka, D., Neumann, J., Giralt, S., et al. (1997). Use of octreotide in the symptomatic management of diarrhea induced by graft-versus-host disease in patients with hematologic malignancies. J Clin Oncol, 5(11):3350–3354.Google Scholar
- Murray, S., Pindoria, S. (2009, January 21). Nurtrition support for bone marrow transplant patients. Retrieved from mrw.interscience.wiley.com: CD002920.Google Scholar