Hepatic sinusoidal obstruction syndrome/veno-occlusive disease (SOS/VOD) still represents one of the most challenging early complications after hematopoietic stem cell transplantation (HSCT), associated with high morbidity and mortality [ 1 , 2 ]. Defibrotide (DF) is approved for SOS/VOD treatment, whereas its prophylactic use is beyond the approved indications of the drug. In recent years, DF has been used as prophylaxis, as per institutional policy, in patients considered at highest risk, although universally shared criteria for identification of eligible patients are still lacking [ 3 , 4 , 5 ].
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Carzaniga et al. (2026) studied this question.
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