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Occurrence of hepatic veno-occlusive disease (VOD) has been reported in up to 60% of patients following stem cell transplantation (SCT). However, the incidence varies widely between studies depending on the type of transplant, conditioning regimen, and criteria used to make the diagnosis. Severe VOD is characterized by high mortality and frequent progression to multiorgan failure (MOF), but to date there has been no consensus on how severity should be evaluated. This review of published reports attempts to clarify these issues by calculating the overall mean incidence of VOD and mortality from severe VOD, examining the effect of changes in SCT practice on the incidence of VOD over time, and discussing the methods used to evaluate severity. The overall mean incidence of VOD was 13.7% (95% confidence interval [CI]=13.3%-14.1%) across 135 studies performed between 1979 and October 2007. The …