Concordance between HokUS-10 scoring and transjugular liver biopsy for the diagnosis of veno-occlusive disease/sinusoidal obstruction syndrome after allogeneic stem cell transplantation.

The aim of this study was to evaluate the concordance between clinical diagnosis and pathological findings of veno-occlusive disease/sinusoidal obstruction syndrome (VOD/SOS) in post-hematopoietic stem cell transplant patients and to investigate the accuracy of the HOKUS-10 score in diagnosing VOD/SOS. We included 13 patients who underwent transjugular liver biopsy for clinical suspicion of VOD/SOS and collected their clinical, laboratory, imaging and pathological data. Eleven patients were confirmed to have VOD/SOS by pathological examination. The median HokUS-10 score and hepatic venous pressure gradient were 6 points (range, 0-10 points) and 13 mmHg (range, 7-24), respectively. There was no significant difference between these scores in VOD/SOS and non-VOD/SOS cases. However, patients with lower HokUS-10 scores tended to have milder histological features of VOD/SOS compared with severe cases. This study highlights the potential discordance between clinical and pathological diagnosis of VOD/SOS and emphasizes the importance of liver biopsy to optimize treatment.