Levels of cytokines, chemokines, and soluble molecules fluctuate after allogeneic hematopoietic stem cell transplantation. These biomarkers may have diagnostic and prognostic value for transplantation-associated coagulopathy （TAC）. Veno-occlusive disease（VOD）is a clinical syndrome characterized by tender hepatomegaly, jaundice, ascites, fluid retention, unexplained weight gain, and transfusion refractory thrombocytopenia. Several approaches have been evaluated for the treatment of VOD, but none has been uniformly effective. Recombinant thrombomodulin（rTM）is composed of the active, extracellular domain of TM. Similar to membrane-bound TM, rTM binds to thrombin to inactive coagulation, and the thrombin-rTM complex activates protein C to produce active protein C, which in the presence of protein S, inactivates factors VIIIa and Va, thereby inhibiting further thrombin formation. In addition, rTM possesses an anti-inflammatory effect of the lectin domain. One cause of TAC, such as VOD, appears to be pro-inflammatory cytokines including high-mobility group box 1 protein. For this reason, it is thought that the direct anti-inflammatory effect of the lectin domain of rTM plays an important role in the therapeutic mechanism for treatment of TAC.