Azathioprine hepatotoxicity after liver transplantation

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

Research output: Contribution to journalArticle

92 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)806-810
Number of pages5
JournalHepatology
Volume14
Issue number5
StatePublished - Nov 1991

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Azathioprine
Liver Transplantation
Liver
Transaminases
Jaundice
Kidney Transplantation
Early Diagnosis
Necrosis
Transplantation
Recurrence
Wounds and Injuries
Serum

ASJC Scopus subject areas

  • Hepatology

Cite this

Sterneck, M., Wiesner, R., Ascher, N., Roberts, J., Ferrell, L., Ludwig, J., & Lake, J. (1991). Azathioprine hepatotoxicity after liver transplantation. Hepatology, 14(5), 806-810.

Azathioprine hepatotoxicity after liver transplantation. / Sterneck, Martina; Wiesner, Russell; Ascher, Nancy; Roberts, John; Ferrell, Linda; Ludwig, Jurgen; Lake, John.

In: Hepatology, Vol. 14, No. 5, 11.1991, p. 806-810.

Research output: Contribution to journalArticle

Sterneck, M, Wiesner, R, Ascher, N, Roberts, J, Ferrell, L, Ludwig, J & Lake, J 1991, 'Azathioprine hepatotoxicity after liver transplantation', Hepatology, vol. 14, no. 5, pp. 806-810.
Sterneck M, Wiesner R, Ascher N, Roberts J, Ferrell L, Ludwig J et al. Azathioprine hepatotoxicity after liver transplantation. Hepatology. 1991 Nov;14(5):806-810.
Sterneck, Martina ; Wiesner, Russell ; Ascher, Nancy ; Roberts, John ; Ferrell, Linda ; Ludwig, Jurgen ; Lake, John. / Azathioprine hepatotoxicity after liver transplantation. In: Hepatology. 1991 ; Vol. 14, No. 5. pp. 806-810.
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