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Defitelio

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"Single-stranded polydeoxyribonucleotide extracted from mammalian organs and used in the treatment of HEPATIC VENO-OCCLUSIVE DISEASE in patients with kidney or lung abnormalities following HEMATOPOIETIC STEM CELL TRANSPLANTATION" www.ncbi.nlm.nih.gov/mesh...

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"Defibrotide is approved for the treatment of adult and pediatric patients with hepatic veno-occlusive disease (VOD), also known as sinusoidal obstruction syndrome (SOS), with renal or pulmonary dysfunction following hematopoietic stem cell transplantation (HSCT)"
dx.doi.org/10.1310/hpj511...

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Consider the potential risk of haematoma from neuraxial anaesthesia in patients on this medication, and particularly in the context of thrombocytopaenia where discussion around risk and benefits should be had with the treating team.

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"Defibrotide has multiple and complex mechanisms of action, including anti-inflammatory, antiatherosclerotic, anti-ischemic, and antithrombotic properties.1,4,7 Studies with defibrotide have also demonstrated increased plasmin activity, promotion of fibrinolysis via upregulation of tissue plasminogen activator and inhibition of tissue factor pathway, reduced circulating levels of plasminogen activator inhibitor-1, and increased concentration of endogenous prostaglandins (I2 and E2), which modulate thrombomodulin, platelets, and fibrinolysis"
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