Enfermedad venooclusiva hepática asociada a terapia con azatioprina en un paciente trasplantado renal / Hepatic veno-occlusive 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 treated with azathioprine, who 18 days after transplantation had a clinically asymptomatic elevation of total bilirrubin and alkaline phosphatases. Nineteen months later, he presented with mild ascites, with a total bilirrubin of 3.5 mg/dl, alkaline phosphatases of 308 U/L (normal <170 U/L) and a prothrombin time at 55 percent of control. A liver biopsy showed sinusoidal and perivenular fibrosis without inflammation, compatible with chronic venous obstruction. Hepatic veno-occlusive disease is an infrequent complication of azathioprine use