ABSTRACT Hepatic veno-occlusive disease (VOD) remains one of the most severe complications of hematopoietic SCT (HSCT). Anticoagulation and thrombolytic therapies using tissue-plasminogen

activator (t-PA) have been used, but are reported to be ineffective and are associated with significant bleeding complications. We analyzed 56 moderate-to-severe post HSCT hepatic VOD cases

treated with t-PA. We analyzed clinical outcomes according to the maximal daily dose of t-PA (t-PAmax) and the severity of VOD. Patients were stratified by t-PAmax⩽10 mg (_n_=37) vs

t-PAmax>10 mg (_n_=19). A higher t-PAmax was associated with increased mortality. Bleeding complications were more likely at higher t-PAmax in both moderate and severe VOD (_P_=0.036,

t-PAmax>10 mg. Our data demonstrate that lower bleeding complications and bleeding-related deaths may result from strict limitations on the t-PAmax without concomitant use of

anticoagulation therapy. However, the overall response and survival outcomes should be re-evaluated by a well-validated study in the future. Access through your institution Buy or subscribe

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study was supported by a grant from the National R&D Program for Cancer Control, Ministry for Health and Welfare, Republic of Korea (1020370). AUTHOR INFORMATION AUTHORS AND AFFILIATIONS

* Department of Hematology, Catholic Blood and Marrow Transplantation Center, Seoul St Mary’s Hospital, The Catholic University of Korea, Seoul, Korea J-H Yoon, W-S Min, H-Je Kim, J-H Kim, 

S-H Shin, S-A Yahng, S-E Lee, B-S Cho, K-S Eom, Y-J Kim, S Lee, C-K Min, S-G Cho, D-W Kim, J-W Lee & C-W Park Authors * J-H Yoon View author publications You can also search for this

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DECLARATIONS COMPETING INTERESTS The authors declare no conflict of interest RIGHTS AND PERMISSIONS Reprints and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Yoon, JH., Min, WS., Kim,

HJ. _et al._ Experiences of t-PA use in moderate-to-severe hepatic veno-occlusive disease after hematopoietic SCT: is it still reasonable to use t-PA?. _Bone Marrow Transplant_ 48, 1562–1568

(2013). https://doi.org/10.1038/bmt.2013.101 Download citation * Received: 19 March 2013 * Revised: 18 June 2013 * Accepted: 18 June 2013 * Published: 29 July 2013 * Issue Date: November

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not currently available for this article. Copy to clipboard Provided by the Springer Nature SharedIt content-sharing initiative KEYWORDS * veno-occlusive disease * hematopoietic SCT *

bleeding * complication * t-PA