In the first few weeks after bone marrow transplantation, a clinical syndrome characterized by hepatomegaly, jaundice, and fluid retention develops in 10 to 70% of patients. This syndrome is due to damage to endothelial cells, sinusoids, and hepatocytes in zone 3 of thejiver acinus. The proximate cause of the damage is cytoreductive therapy. This syndrome, often called veno-occlusive disease of the liver, can vary in severity from mild reversible disease to fatal disease associated with multiorgan failure