LIVER INJURY IN KIDNEY TRANSPLANT PATIENTS:RECEIVING AZATHIOPRINE

概要

論文の詳細を見る
Liver injury in 29 kidney transplant patients receiving azathioprine was retrospectively reviewed to determine the cause and appropriate management. Sixty-two percent of renal allograft recipients had evidence of hepatic dysfunction, as indicated by serum transaminase levels greater than 200 I. U. In 10 patients, hepatic dysfunction with mild elevations of serum transaminase occurred temporalily and had good prognosis. While six of 8 patients with marked elevations of serum alkaline phosphatase activity and bilirubin concentration, which appeared 3 months following kidney transplantation and thereafter persisted for more than 6 months, had serious complications and died. Of 5 patients with hepatic tissue available for histopathological study, only two patients demonstrated changes suggestive of acute and chronic persistent hepatitis. There was no consistent histopathological pattern but proliferation of bile ductules, centrolobular necrosis with fatty metamorphosis and hemosiderosis. In most of these severe cases, hepatitis B virus, cytomegalovirus and herpesvirus could not be implicated and azathioprine-direct hepatotoxicity not be considered to be the likely causes. However, kidney transplant recipients receiving azathioprine may be more prone to virus infection causing liver injury due to an adverse effect of immunosuppression. A reduction in total immunosuppression or discontinuation of azathioprine is recommended to manage transplant patients with liver injury.
財団法人日本消化器病学会の論文

LIVER INJURY IN KIDNEY TRANSPLANT PATIENTS:RECEIVING AZATHIOPRINE

スポンサーリンク

概要

著者

関連論文

スポンサーリンク