An excerpt of defibrotide for prophylaxis of sinusoidal obstruction syndrome/veno-occlusive disease （SOS/VOD） in pediatric high-risk patients： Consensus guidelines from the European Society for Blood and Marrow Transplantation （EBMT） （2026 edition）

Sinusoidal obstruction syndrome/veno-occlusive disease （SOS/VOD） after hematopoietic stem cell transplantation （HSCT） in children has high incidence and mortality rates， and missed diagnosis of jaundice-free cases is common. In addition， there are still controversies over the efficacy of prophylactic defibrotide （DF） use， and the European Medicines Agency does not recommend the prophylactic use of DF， whereas clinical needs remain urgent. In 2026， by integrating controversial research evidence and focusing on specific prophylaxis for high-risk children， the European Society for Blood and Marrow Transplantation established a weighted cumulative scoring system to quantify risks and accurately identify the populations who may benefit from DF prophylaxis， in order to provide evidence-based support for the prophylactic use of DF， reduce the incidence and mortality rates of SOS/VOD in children， and improve the prognosis of patients. This article gives an excerpt of the key points in the consensus guidelines.