text: <unk>  is characterized by tender hepatomegaly, ascites, and weight gain. It is most commonly a complication of hematopoietic cell transplantation (HCT). The incidence and severity of<unk>  depends on the conditioning regimen used and presence of pre-existing liver disease. There is no established system for the classification of<unk> . However, it can be classified on the basis of severity as mild, moderate and severe. It is thought that pre-existing liver disease increases the risk of developing<unk>  <unk>  due to impairment of drug metabolism which predisposes to the endothelial injury. The deposition of fibrinogen and factor VIII within the sinusoids leads to their dilation and congestion by erythrocytes. The progressive occlusion of venules leads to widespread zonal liver disruption and centrilobular hemorrhagic necrosis. The two established criteria for the clinical diagnosis of<unk>  are Baltimore criteria and modified Seattle criteria. Patients with a mild or moderate form of<unk>  require no specific therapy and can be managed with supportive care alone. If left untreated, the severe form of<unk>  is characterized by high mortality and progression to multiorgan failure. The most accurate method to confirm the diagnosis and evaluate the severity of<unk>  is the measurement of the hepatic venous gradient pressure (HVGP). The patient with suspected<unk>  <unk>  requires the following lab studies: complete blood count, liver function tests, complete metabolic profile and viral hepatitis serologies. A transjugular liver biopsy can be helpful in the diagnosis of<unk> . Common findings on liver biopsy include<unk>  dilation and congestion by erythrocytes and thrombi within the terminal hepatic venules.
  The management of<unk>  depends on the severity of the disease. Supportive care is the mainstay of therapy for mild and moderate<unk> . The severe form of<unk>  needs defibrotide (thrombolytic agent) along with supportive care. 
  Surgical treatment of<unk>  is reserved for patients who do not respond to supportive treatment or defibrotide. The surgical options include transjugular intrahepatic portosystemic shunt (TIPS) and liver transplantation.
  Primary preventive measures of<unk>  include minimizing risks related to the transplant process such as the source of the graft (allogeneic greater than autologous), choice of chemotherapy and use of antimicrobials. The exposure to the hepatotoxic agents should be minimized and preexisting liver diseases should be managed. The prophylaxis for graft vs host disease should be considered.
option_0: Sinusoidal obstruction syndrome
option_1: Choroidal effusion
option_2: Acute viral nasopharyngitis
option_3: Rhinosinusitis
option_4: Sinusitis
option_5: Sinusitis  
option_6: Empty sella syndrome
option_7: Nasal polyp