去纤苷治疗肝静脉闭塞有哪些禁忌?

Contraindications of defibrotide in the treatment of hepatic veno-occlusion

Defibrotide is contraindicated in the treatment of hepatic veno-occlusion and is contraindicated in patients receiving concomitant systemic anticoagulant or fibrinolytic therapy; and in patients with known hypersensitivity to defibrotide or any of its excipients.

1. Increases the activity of fibrinolytic enzymes in vitro and may increase the risk of bleeding in VOD (hepatic veno-occlusive disease) patients after hematopoietic stem cell transplantation (HSCT). Do not initiate defibrotide therapy in patients with active bleeding.

2. Monitor patients for hypersensitivity reactions, especially if there is a history of prior exposure. If a severe hypersensitivity reaction occurs, discontinue use of defibrotide.

3. There is no data on the use of defibrotide in pregnant women to inform pregnant women of the potential risk of miscarriage.

4. Due to the potential for serious adverse reactions, including bleeding in breastfed infants, patients are advised not to breastfeed during treatment with defibrotide.

The most common adverse reactions (incidence ≥10%) with defibrotide for hepatic veno-occlusion are hypotension, diarrhea, vomiting, nausea, and epistaxis. The most common serious adverse reactions (incidence ≥5%) were hypotension (11%) and alveolar hemorrhage (7%).

The recommended dose of defibrotide for the treatment of adult and pediatric patients with hepatic veno-occlusion is 25.6 mg/kg every 6 hours as an intravenous infusion over 2 hours. Dosage should be based on the patient's baseline weight, defined as the patient's weight before preparation for the HSCT (hematopoietic stem cell transplant) protocol. Use defibrotide for at least 21 days. If signs and symptoms of hepatic VOD (hepatic veno-occlusive disease) do not resolve after 21 days, continue using defibrotide until VOD resolves or for up to 60 days.

What are the functions of defibrinoside?

Defibrotide protects ECs from damage caused by chemotherapy, tumor necrosis factor-α (TNF-α), serum starvation, and perfusion. In vitro, defibrotide reduced the expression of von Willebrand factor (vWF) and plasminogen activator inhibitor-1 (PAI-1), thereby reducing EC activation and increasing EC-mediated fibrinolysis.

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