Defibrotide is mainly used to treat hepatic vein occlusion (VOD) after hematopoietic stem cell transplantation, and its use requires special attention to bleeding risk monitoring and special population management. The following will explain from two aspects: indications and precautions.

1 Indications

(1) Main indications

Suitable for adult and pediatric patients (≥ 1 month of age) with hepatic vein occlusion (VOD) and multiple organ failure (MOF) after hematopoietic stem cell transplantation (HSCT).

(2) Other applications

Clinical studies have shown that it may be effective for non HSCT related VOD, but it needs to be used beyond the instructions after strict evaluation by doctors.

2 Medication precautions

(1) Bleeding risk monitoring

During treatment, it is necessary to closely monitor bleeding signs, especially for patients with thrombocytopenia or coagulation dysfunction. If necessary, adjust the dosage or suspend medication.

(2) Allergic reactions

After the first medication, it should be observed for at least 2 hours. If allergic symptoms such as urticaria and difficulty breathing occur, the medication should be stopped immediately and treated.

(3) Special populations

Pregnant women are prohibited from using it; Breastfeeding women should pause breastfeeding; The dosage of medication for children should be strictly adjusted according to their weight; Elderly people do not require special dosage adjustments.

(4) Drug interactions

The combination of anticoagulant/antiplatelet drugs may increase the risk of bleeding and requires close monitoring of coagulation function.

(5) Laboratory monitoring

During the treatment period, it is necessary to regularly check liver function, kidney function, and coagulation indicators, and adjust the treatment plan based on the results.