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Title

Successful treatment of severe azathioprine-induced hepatic veno-occlusive disease in a kidney-transplanted patient with transjugular intrahepatic portosystemic shunt

Authors
Azoulay, D
Castaing, D
Lemoine, A
Samuel, D
Reynes, M
Charpentier, B
Bismuth, H
Published in Clinical Nephrology. 1998, vol. 50, no. 2, p. 118-22
Abstract Azathioprine-induced veno-occlusive disease of the liver mainly described after kidney transplantation is as rare as severe with a high mortality due to acute portal hypertension and liver failure. A kidney-transplanted patient with severe azathioprine-induced veno-occlusive disease of the liver and worsening despite drug discontinuation was treated by emergency transjugular intrahepatic portosystemic shunt. Whereas the veno-occlusive disease was controlled, the patient developed severe intractable portosystemic encephalopathy successfully treated by a stent reducer maintaining a certain degree of portal diversion. Twelve months after transjugular intrahepatic portosystemic shunt, liver function was normalized and the stent was thrombosed with a subnormal liver histology. Thirty-six months after transjugular intrahepatic portosystemic shunt the patient is alive with normal liver function tests and kidney graft function. Transjugular intrahepatic portosystemic shunt for treatment of severe veno-occlusive disease of the liver is an alternative to tide the patient over until recovery of liver function.
Keywords AdultAzathioprine/adverse effects/therapeutic useBiopsyHepatic Veno-Occlusive Disease/chemically induced/pathology/surgeryHumansImmunosuppressionImmunosuppressive Agents/adverse effects/therapeutic useKidney TransplantationLiver/pathologyMalePortasystemic Shunt, Transjugular Intrahepatic
Identifiers
PMID: 9725784
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Research group Hépatologie chirurgicale (327)
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AZOULAY, D et al. Successful treatment of severe azathioprine-induced hepatic veno-occlusive disease in a kidney-transplanted patient with transjugular intrahepatic portosystemic shunt. In: Clinical Nephrology, 1998, vol. 50, n° 2, p. 118-22. https://archive-ouverte.unige.ch/unige:73141

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Deposited on : 2015-06-10

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