Ultrasounds may enable earlier predictions and interventions for a transplant complication

Blood stem cell transplantation can have side effects, such as disrupting blood flow in the liver, a situation that can cause the condition known as sinusoidal obstruction syndrome (SOS) or veno-occlusive disease (VOD). If left unchecked, SOS/VOD can be fatal, but early detection and intervention are associated with good outcomes. To identify biomarkers associated with SOS/VOD and thus enable earlier detection, researchers led by Akshay Sharma, MBBS, MSc, Department of Bone Marrow Transplantation & Cellular Therapy, analyzed ultrasound imaging from 398 patients. They assessed how well different parameters predicted SOS/VOD development. The scientists confirmed the known biomarkers: ascites severity (abdominal fluid buildup), hepatomegaly (enlargement of the liver) and gallbladder thickness. They also identified new highly predictive features, including the Doppler perfusion index, which compares blood flow coming from the main artery to the liver to total blood flow in the liver, and liver stiffness. Together, the results may help establish a future ultrasound-based system to predict SOS/VOD earlier, enabling more effective interventions that improve outcomes. The findings were published in Bone Marrow Transplantation.

“SOS/VOD is a very serious complication after blood stem cell transplantation that is sometimes tricky to diagnose,” Sharma said. “We believe these ultrasound parameters will help us make the diagnosis more quickly and accurately, therefore leading to more efficient treatment and better outcomes.”

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