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- W2060789725 abstract "603 Azathioprine (AZA) has been used for decades and still today it is not clear whether its use is harmful to renal transplanted (RTx) patients with chronic hepatitis C or B. To determine the effects of AZA in the long term course of RTx patients with hepatitis C, B or both, we reviewed 79 such patients transplanted between 1973 and 1990. Patients were grouped according to whether they had AZA withdrawn from the immunossupressive regimen (Group I, n=45) or the AZA dosage had been reduced only (from 2.3±0.4 to 1.5±0.5 mg/kg/d. p=0.001) (Group II, n=34). The decision to remove or to keep AZA was restricted to the patient's doctor. Groups were similar in terms of type of the hepatitis C, B or both (33/7/5 vs 22/11/1), gender, age, immunosuppression and follow-up after RTx (89±45 vs 76±29 mo). At the time of AZA changing, serum ALT (66±55 vs 63±96U/L), SCr(1.2±0.3 vs 1.20.3 mg/dl) and total bilirrubin(2.2±2.2 vs 2.4±5.3 mg/dl) were similar in GI and GII, respectively. However, AZA dosage (1.9±0.4 vs 2.3±0.4mg/kg/d,p=0.001) was higher in GII while γ-GT serum levels(224±229 vs 145±159U/L, p=0.04) were higher in GI. After an equal time of follow-up after the AZA changing (64±26 vs 58±29 mo.), patients in GI showed a decrease in the serum liver parameters when compared to baseline: ALT: 38±40UI, p=0.001; γ-GT: 94±107UI, p=0.001; total bilirrubin: 1.3±1.5mg/dl,p=0.002, whereas in GII only ALT decreased (34±33UI/I,p=0.04) while γ-GT(114±99UI/I) and total bilirrubin (2.4±4.6mg/dl) did not. Compared to baseline, SCr increased only in GI (1.9±1.2mg/dl, p=0.001) but, at last follow-up, did not differ from GII (1.6±1.2mg/dl). This increase in SCr could not be attributed to CYA introduction in GI patients not using CYA before, since SCr increased equally in those who were already on CYA compared to those who were not. The intention to perform liver biopsies was equal in GI and GII (16 vs 14) but the hystological findings of severe chronic liver disease (either chronic active hepatitis or cirrhosis) were more frequent in GII (p=0.004). Death with a functioning graft was much more frequent in GII than in GI (p=0.001). Infection and cirrhosis were more frequent as a cause of death in GII than in GI. We concluded that AZA is harmful to RTx patients with both chronic hepatitis C and B and,. therefore should be avoided. AZA withdrawal, but not the dose decrease, diminishes the serum liver enzymes and the progression rate of the chronic viral liver disease as well as the chances of death with a functioning graft." @default.
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- W2060789725 date "1998-05-01" @default.
- W2060789725 modified "2023-09-27" @default.
- W2060789725 title "IS AZATHIOPRINE HARMFUL TO CHRONIC VIRAL HEPATITIS IN RENAL TRANSPLANTATION? A LONG-TERM FOLLOW-UP STUDY ON AZATHIOPRINE WITHDRAWAL" @default.
- W2060789725 doi "https://doi.org/10.1097/00007890-199805131-00601" @default.
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