Jones et al used clinical signs and symptoms to diagnose veno-occlusive disease (VOD) after bone marrow transplantation. The authors are from the Johns Hopkins University.


Criteria for the clinical diagnosis of veno-occlusive disease – all of the following:

(1) onset within 21 days after transplant (day 0 = day of transplantation)

(2) hyperbilirubinemia with serum bilirubin > 2 mg/dL

(3) 2 or 3 of the following clinical findings:

(3a) ascites

(3b) hepatomegaly, with or without right upper quadrant pain

(3c) unexplained weight gain > 5% above baseline

(4) no other identifiable cause for liver disease present


The diagnosis of VOD was made if:

(1) the patient met the clinical criteria, OR

(2) liver biopsy showed histologic evidence of VOD


Resolution of VOD was defined as when the serum bilirubin was <= 1.4 mg/dL.


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