Diagnosis and severity criteria for sinusoidal obstruction syndrome/veno-occlusive disease in adult patients: a refined classification from the European society for blood and marrow transplantation (EBMT)

Bone Marrow Transplant. 2023 Jul;58(7):749-754. doi: 10.1038/s41409-023-01992-8. Epub 2023 Apr 24.


Sinusoidal obstruction syndrome, also known as veno-occlusive disease (SOS/VOD), is a potentially life-threatening complication that can develop after hematopoietic cell transplantation (HCT). A new definition for diagnosis, and a severity grading system for SOS/VOD in adult patients, was reported a few years ago on behalf of the European Society for Blood and Marrow Transplantation (EBMT). The aim of this work is to update knowledge regarding diagnosis and severity assessment of SOS/VOD in adult patients, and also its pathophysiology and treatment. In particular, we now propose to refine the previous classification and distinguish probable, clinical and proven SOS/VOD at diagnosis. We also provide an accurate definition of multiorgan dysfunction (MOD) for SOS/VOD severity grading based on Sequential Organ Failure Assessment (SOFA) score.

Publication types

  • Review

MeSH terms

  • Adult
  • Bone Marrow
  • Hematopoietic Stem Cell Transplantation* / adverse effects
  • Hepatic Veno-Occlusive Disease* / diagnosis
  • Hepatic Veno-Occlusive Disease* / drug therapy
  • Hepatic Veno-Occlusive Disease* / etiology
  • Humans
  • Syndrome
  • Vascular Diseases*