This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (52)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

Patricia Ireland, MD; Abdur Rashid, MD, FRCP (C); Franz von Lichtenberg, MD; Tito Cavallo, MD; John P. Merrill, MD

Arch Intern Med. 1973;132(1):29-37.

Abstract
The liver disease in 24 kidney transplant patients receiving azathioprine was reviewed to determine the cause and appropriate management. Azathioprine hepatotoxicity could not be implicated in any of the 24 patients, and there was no correlation between the course of the liver disease and azathioprine administration and withdrawal. Seven patients had "nonspecific reactive hepatitis" associated with sepsis and other complications; 12 patients had viral hepatitis, based on the clinical course, histopathologic and laboratory findings, and tests for Australia antigen; and in five patients the cause of the liver disease could not be determined. The high morbidity of viral hepatitis in these patients (fulminant hepatitis in one and post-necrotic cirrhosis in two) suggested an adverse effect of immunosuppression. Liver disease is not an indication to discontinue azathioprine therapy, but rather to reduce total immunosuppression whenever possible.

Author Affiliations
Boston

From the departments of medicine (Drs. Ireland, Rashid, and Merrill) and pathology (Drs. von Lichtenberg and Cavallo), Peter Bent Brigham Hospital, Boston. Dr. Ireland is presently with Bernalillo County Medical Center, Albuquerque, NM, Dr. Rashid is at Ottawa General Hospital, Ottawa, and Dr. Cavallo is at Montefiore Hospital, Pittsburgh.

Footnotes
Received for publication Feb 24, 1972; accepted May 19.

Reprint requests to Bernalillo County Medical Center, 2211 Lomas Blvd NE, Albuquerque, NM 87106 (Dr. Ireland).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Hepatic Veno-occlusive Disease Associated with Renal Transplantation and Azathioprine Therapy
READ et al.
ANN INTERN MED 1986;104:651-655.
ABSTRACT  

Liver Disease in Renal Transplant Recipients
Anuras et al.
Arch Intern Med 1977;137:42-48.
ABSTRACT  

Altered Reticuloendothelial Function in Long-Term Renal Allograft Recipients
Drivas et al.
Arch Surg 1976;111:1368-1371.
ABSTRACT  

Parenterally Transmitted Hepatitis A Associated with Platelet Transfusions: Epidemiologic Study of an Outbreak in a Marrow Transplantation Center
MEYERS et al.
ANN INTERN MED 1974;81:145-151.
ABSTRACT