Diagnosis of hepatic veno-occlusive disease by plasminogen activator inhibitor-1 plasma antigen levels: A prospective analysis in 350 allogeneic hematopoietic stem cell recipients

Markus Pihusch, Holger Wegner, Peter Goehring, Christoph Salat, Verena Pihusch, Erhard Hiller, Reinhard Andreesen, Hans Jochem Kolb, Ernst Holler, Rudolf Pihusch

Research output: Contribution to journalArticlepeer-review

36 Scopus citations

Abstract

Background. Veno-occlusive disease (VOD) is one of the most serious complications following allogeneic hematopoietic stem cell transplantation (HSCT) and is associated with a high mortality. We conducted a large trial in order to investigate the value of plasminogen activator inhibitor-1 (PAI-1) plasma antigen levels in VOD patients as PAI-1 has been described as a possible diagnostic marker of VOD. Methods. In all, 350 stem cell recipients were included in our study. PAI-1 levels were analyzed prior to conditioning therapy and then weekly until eight weeks after HSCT. Transplantation-related complications (TRC) including VOD, microangiopathic hemolytic anemia (MAHA), and graft-versus-host disease (GVHD) were recorded weekly throughout the study. Results. Maximum PAI-1 antigen levels were increased in all patients with VOD (n = 15; mean 248 ng/ml; 95% CI 183-314 ng/ml). Maximum PAI-1 levels above 120 ng/ml showed a sensitivity of 100% and a specificity of 30.6% for VOD after HSCT. Conclusion. Our study underlines that maximum PAI-1 plasma antigen levels not exceeding 120 ng/ml have a strong negative predictive value in the diagnosis of VOD and thus represent a helpful non-invasive tool for exclusion of VOD after HSCT.

Original languageEnglish
Pages (from-to)1376-1382
Number of pages7
JournalTransplantation
Volume80
Issue number10
DOIs
StatePublished - Nov 2005
Externally publishedYes

Keywords

  • Hematopoietic stem cell transplantation
  • Plasminogen activator inhibitor-1
  • Veno-occlusive disease

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