McDonald et al modified their original criteria for the diagnosis of veno-occlusive disease (VOD) occurring after bone marrow transplantation. The authors are from the Fred Hutchinson Cancer Research Center, VA Medical Center and University of Washington in Seattle.


Criteria for the diagnosis of VOD:

(1) onset within 20 days after transplantation

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

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

(2b) hepatomegaly with right upper quadrant pain

(2c) weight gain > 2% from baseline body weight due to fluid accumulation



• Day 0 = day of the marrow infusion.


Uncertain for the diagnosis of VOD:

(1) only 1 of the clinical findings present, OR

(2) other confounding factors present (septicemia, congestive heart failure, pancreatitis, hyperacute graft vs host disease, fungal liver disease, other)


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