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. 2020 Apr 21;190(4):508–519. doi: 10.1111/bjh.16621

Table 2.

Summary of common EC dysfunction syndromes after HCT. 15 , 16 , 25 , 42 , 43 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60

Syndrome Incidence Risk factors Organ complications Mortality
VOD/SOS 14% (up to 40%)
  • Conditioning regimen

  • Type and number of transplants

  • Older age

  • Lower performance status

  • Pre‐existing liver disease

  • Postsinusoidal hypertension

  • Hepatorenal failure

  • Pulmonary failure

Severe VOD/SOS with MOD: up to 50–70%
GvHD 40–50%
  • Degree of HLA mismatch

  • Patient age

  • Inadequate GvHD prophylaxis

  • Gender disparity

  • Multiparous female donors

  • Presence of pretransplant comorbidities

  • Intensity of the HCT conditioning regimen

  • Use of TBI

  • Source of donor graft

  • Intestinal dysbiosis

  • Skin, liver, upper and lower GI tract, immune system

15–30%
TA‐TMA 10–35%
  • Patient age

  • Donor type

  • Degree of HLA mismatch

  • Intensity of the HCT conditioning regimen

  • Use of TBI

  • Hypertension

  • Renal failure

  • CNS dysfunction

Rates range widely due to the lack of clear diagnostic guidelines
IPS/DAH

IPS: 2–15%

DAH: 5–12%

  • Myeloablative conditioning

  • Use of TBI

  • Older age

  • Presence of AGvHD

  • Prior autologous HCT

  • Lung injury (pulmonary oedema, inflammation, increased permeability)

  • Respiratory failure

60–80%

AGvHD, acute graft‐versus‐host disease; CNS, central nervous system; EC, endothelial cell; GI, gastrointestinal; GvHD; graft‐versus‐host disease; HCT, haematopoietic cell transplantation; HLA, human leukocyte antigen, IPS/DAH, idiopathic pneumonia syndrome/diffuse alveolar haemorrhage; MOD, multiorgan dysfunction; TA‐TMA, transplant‐associated thrombotic microangiopathy; TBI, total body irradiation; VOD/SOS, veno‐occlusive disease/sinusoidal obstruction syndrome.