HEPATIC VENOOCCLUSIVE DISEASE-ASSOCIATED TO THE USE OF AZATHIOPRINE IN A RENAL-TRANSPLANT RECIPIENT

We report a 30 years old male, recipient of a kidney allograft and tre ated with azathioprine, who eighteen days after transplantation had a clinically asymptomatic elevation of total bilirubin and alkaline phos phatases. Nineteen months later, he presented with mild ascites, with a total bilirubin of 3.5 mg/dl, alkaline phosphatases of 308 U/L (norm al <170 U/L) and a prothrombin time at 55% of control. A liver biopsy showed sinusoidal and perivenular fibrosis without inflammation, compa tible with chronic venous obstruction. Hepatic veno-occlusive disease is an infrequent complication of azathioprine use.