1984
DOI: 10.1159/000199104
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Favourable Outcome of Hepatic Veno-Occlusive Disease in a Renal Transplant Patient Receiving Azathioprine, Treated by Portacaval Shunt

Abstract: Veno-occlusive disease (VOD) developed in a 4 5-year-old white male 2 years after cadaveric kidney transplantation while receiving combined immunosuppressive therapy with prednisone and azathioprine. Early clinical signs at presentation included ascites and tender hepatomegaly. The diagnosis of VOD was established at laparoscopy and by histological examination of liver biopsies. Azathioprine was discontinued. Gross ascites refractory to medical treatment and decreasing liver function required surgical treatmen… Show more

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Cited by 30 publications
(19 citation statements)
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“…and nodular regenerative hyperplasia. [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] It has been speculated that all of these lesions are related to sinusoidal endothelial damage or disruption of the hepatic microcirculation. 10,[21][22][23][24] Azathioprine is extensively meAbbreviations: HVOD, hepatic venoocclusive disease; SEC, sinusoidal epithelial cells; GSH, glutathione; DMEM, Dulbecco's minimum essential metabolized in the small intestine and liver by GSH Sdium; MTT, [3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium; ANOVA, transferase to 6-mercaptopurine.…”
Section: Prine Maintained Intracellular Gsh Levels Better Thanmentioning
confidence: 99%
“…and nodular regenerative hyperplasia. [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] It has been speculated that all of these lesions are related to sinusoidal endothelial damage or disruption of the hepatic microcirculation. 10,[21][22][23][24] Azathioprine is extensively meAbbreviations: HVOD, hepatic venoocclusive disease; SEC, sinusoidal epithelial cells; GSH, glutathione; DMEM, Dulbecco's minimum essential metabolized in the small intestine and liver by GSH Sdium; MTT, [3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium; ANOVA, transferase to 6-mercaptopurine.…”
Section: Prine Maintained Intracellular Gsh Levels Better Thanmentioning
confidence: 99%
“…It has since been related to the use of cytotoxic drugs [6][7][8][9][10][11][12][13][14][15] and radiotherapy [16]. VOD has also been associated with various clinical situations: hereditary tyrosinemia [17], kidney transplants [8,[18][19][20][21], bone marrow allografts [6, 11-13, 15, 22-24], familial immunodeficiency [25], use of contraceptives [26], alcoholism [27], systemic lupus erythematosus [28,29], the Spanish toxic oil syndrome [30] and abetalipoproteinemia [31].…”
Section: Introductionmentioning
confidence: 99%
“…Despite the high rate of hepatic affectation in renal transplant patients mentioned in the literature [32][33][34][35][36][37][38][39][40][41][42] and the high number of patients undergoing transplants, VOD has only been reported in 12 kidney allograft recip ients [8,[18][19][20][21], This work reports 5 new cases of VOD in kidney transplant patients. It analyses the insidious presentation of the disease, its clinical outcome and some aspects probably related with etiology: the history of a previous hepatic viral infection and the use of azathioprine em ployed as immunosuppressive agent.…”
Section: Introductionmentioning
confidence: 99%
“…[8][9][10] The easily recognizable central vein occlusion occurring in patients with this condition inspired the name hepatic veno-occlusive disease. Nonetheless, central vein involvement is not an essential feature because the disease process originates in the sinusoids.…”
mentioning
confidence: 99%
“…10 The incidence of clinical SOS in the largest series of LT recipients was 1.9%; this value contrasts with the 43% rate of silent reversible hepatic venular stenosis reported in another study. 9 In this setting, SOS is considered a part of the cellular rejection process with an endothelial predilection and is mainly related to azathioprine. There are no reports of a relationship between SOS and tacrolimus or any of the antiviral drugs used in our patient.…”
mentioning
confidence: 99%