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Utility of liver stiffness measurement in the diagnosis of sinusoidal obstruction syndrome/veno-occlusive disease after hematopoietic stem cell transplantation

  • Original Article–Gastroenterology
  • Published:
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Abstract

Purpose

We aimed to assess the role of liver stiffness measurement (LSM), evaluated using transient elastography (TE), for the diagnosis of sinusoidal obstruction syndrome (SOS)/veno-occlusive disease (VOD), a complication of hematopoietic stem cell transplantation (HSCT).

Methods

In this retrospective study, ultrasonography (US) and LSM were performed on 86 adult patients (55 men and 31 women) undergoing HSCT between January 2016 and December 2022. Characteristics and changes in liver stiffness (LS) were compared between patients with and without SOS/VOD.

Results

Of the 86 patients, 14 were diagnosed with SOS/VOD. A significant increase in LS (ranging from 12.6 to 55.1 kPa, median 23.8 kPa) compared to pre-HSCT values was observed in all patients who developed SOS/VOD. The area under the receiver operating characteristic curve (AUROC) for the diagnosis of SOS/VOD was 0.9663 (0.933–0.995) for LS ≥ 17.4 kPa after HSCT. Post-transplant LS exceeded 17.4 kPa in all 14 patients in the SOS/VOD group (100%) and in seven patients in the non-SOS/VOD group (9.7%). The sensitivity and specificity were 100% and 90.3%, respectively. AUROC for the diagnosis of SOS/VOD was 0.973 (0.943–1.000) for LS increase ≥  + 12.6 kPa from baseline after HSCT. The change of ≥  + 12.6 kPa from baseline was observed in all 14 patients in the SOS/VOD group (100%) and in four patients in the non-SOS/VOD group (5.6%). The sensitivity and specificity were 100% and 94.4%, respectively.

Conclusion

LSM using TE may contribute to establishing the diagnosis of SOS/VOD after HSCT.

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Data availability

The datasets used and/or analysed in this study are available from corresponding author on reasonable request.

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Acknowledgements

We thank Yoko Ugajin for her contribution to conducting the examinations as a laboratory technician.

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Authors and Affiliations

  1. Department of Clinical Laboratory, Toranomon Hospital Kajigaya, 1-3-1 Kajigaya, Takatsu, Kawasaki, Kanagawa, 213-8587, Japan

    Yoshiko Inoue, Hideyuki Denpo, Kazuma Yamaguchi, Koichi Kubota & Akiko Masuda

  2. Department of Hepatology, Toranomon Hospital, 2-2-2 Toranomon, Minato, Tokyo, 105-8470, Japan

    Satoshi Saitoh

  3. Department of Hematology, Toranomon Hospital Kajigaya, 1-3-1 Kajigaya, Takatsu, Kawasaki, Kanagawa, 213-8587, Japan

    Yuki Taya, Atsushi Wake & Kazuya Ishiwata

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  1. Yoshiko Inoue
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Correspondence to Yoshiko Inoue.

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Conflict of interest

All the authors declare that there are no conflicts of interest. With permission from The Japan Society of Ultrasonics in Medicine, some information from the following case report has been adapted: A case of late-onset hepatic sinusoidal obstruction syndrome/veno-occlusive disease after hematopoietic stem cell transplantation: usefulness of ultrasonography (liver stiffness measurement) for diagnosis and follow-up (Jpn J Med Ultrasonic 2022;49:433–440).

Ethical statements

The study protocol complied with the tenets of the Declaration of Helsinki. This retrospective study was approved by the institutional review board at Toranomon Hospital (2149-B). We used the opt-out method to obtain informed consent in this study.

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Inoue, Y., Saitoh, S., Denpo, H. et al. Utility of liver stiffness measurement in the diagnosis of sinusoidal obstruction syndrome/veno-occlusive disease after hematopoietic stem cell transplantation. J Med Ultrasonics 51, 311–321 (2024). https://doi.org/10.1007/s10396-023-01392-x

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  • DOI: https://doi.org/10.1007/s10396-023-01392-x

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