Azathioprine hepatotoxicity after liver transplantation

Martina Sterneck; Russell Wiesner; Nancy Ascher; John Roberts; Linda Ferrell; Jurgen Ludwig; John Lake

doi:10.1002/hep.1840140511

Azathioprine hepatotoxicity after liver transplantation

Martina Sterneck, Russell Wiesner, Nancy Ascher, John Roberts, Linda Ferrell, Jurgen Ludwig, John Lake

Gastroenterology and Hepatology

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94 Scopus citations

Abstract

We report the first two cases of apparent azathioprine hepatotoxicity occurring after liver transplantation. The two patients exhibited jaundice, elevated serum transaminase activities and histopathological features of sinusoidal congestion and centrilobular hepatocellular degeneration 17 and 61 days after transplantation. After withdrawal of azathioprine, liver test results improved immediately in both patients. Recurrence of liver injury after another challenge with azathioprine was seen in the first case. Previously, fatal venoocclusive disease occurring after kidney transplantation had been attributed to azathioprine. Irreversible venoocclusive disease and the reversible hepatotoxicity described in this report (i.e., sinusoidal congestion with centrizonal necrosis) most likely represent different stages of hepatic endotheliitis caused by azathioprine. Thus early diagnosis of azathioprine hepatotoxicity is of great importance. (HEPATOLOGY 1991;14:806–810).

Original language	English (US)
Pages (from-to)	806-810
Number of pages	5
Journal	Hepatology
Volume	14
Issue number	5
DOIs	https://doi.org/10.1002/hep.1840140511
State	Published - Nov 1991

ASJC Scopus subject areas

Hepatology

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10.1002/hep.1840140511

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title = "Azathioprine hepatotoxicity after liver transplantation",

abstract = "We report the first two cases of apparent azathioprine hepatotoxicity occurring after liver transplantation. The two patients exhibited jaundice, elevated serum transaminase activities and histopathological features of sinusoidal congestion and centrilobular hepatocellular degeneration 17 and 61 days after transplantation. After withdrawal of azathioprine, liver test results improved immediately in both patients. Recurrence of liver injury after another challenge with azathioprine was seen in the first case. Previously, fatal venoocclusive disease occurring after kidney transplantation had been attributed to azathioprine. Irreversible venoocclusive disease and the reversible hepatotoxicity described in this report (i.e., sinusoidal congestion with centrizonal necrosis) most likely represent different stages of hepatic endotheliitis caused by azathioprine. Thus early diagnosis of azathioprine hepatotoxicity is of great importance. (HEPATOLOGY 1991;14:806–810).",

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T1 - Azathioprine hepatotoxicity after liver transplantation

AU - Sterneck, Martina

AU - Wiesner, Russell

AU - Ascher, Nancy

AU - Roberts, John

AU - Ferrell, Linda

AU - Ludwig, Jurgen

AU - Lake, John

PY - 1991/11

Y1 - 1991/11

N2 - We report the first two cases of apparent azathioprine hepatotoxicity occurring after liver transplantation. The two patients exhibited jaundice, elevated serum transaminase activities and histopathological features of sinusoidal congestion and centrilobular hepatocellular degeneration 17 and 61 days after transplantation. After withdrawal of azathioprine, liver test results improved immediately in both patients. Recurrence of liver injury after another challenge with azathioprine was seen in the first case. Previously, fatal venoocclusive disease occurring after kidney transplantation had been attributed to azathioprine. Irreversible venoocclusive disease and the reversible hepatotoxicity described in this report (i.e., sinusoidal congestion with centrizonal necrosis) most likely represent different stages of hepatic endotheliitis caused by azathioprine. Thus early diagnosis of azathioprine hepatotoxicity is of great importance. (HEPATOLOGY 1991;14:806–810).

AB - We report the first two cases of apparent azathioprine hepatotoxicity occurring after liver transplantation. The two patients exhibited jaundice, elevated serum transaminase activities and histopathological features of sinusoidal congestion and centrilobular hepatocellular degeneration 17 and 61 days after transplantation. After withdrawal of azathioprine, liver test results improved immediately in both patients. Recurrence of liver injury after another challenge with azathioprine was seen in the first case. Previously, fatal venoocclusive disease occurring after kidney transplantation had been attributed to azathioprine. Irreversible venoocclusive disease and the reversible hepatotoxicity described in this report (i.e., sinusoidal congestion with centrizonal necrosis) most likely represent different stages of hepatic endotheliitis caused by azathioprine. Thus early diagnosis of azathioprine hepatotoxicity is of great importance. (HEPATOLOGY 1991;14:806–810).

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Azathioprine hepatotoxicity after liver transplantation

Abstract

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