Figure 710

Liver disease after kidney transplant. Biochemical abnormalities reflecting liver injury have been reported in 7% to 34% of kidney recipients in the early period after transplantation [23,82-86]. Morbidity and mortality associated with liver disease, however, are rarely seen until the second decade after transplantation [87]. Liver dysfunction can be secondary to viral infections, such as hepatitis B and C, herpes simplex virus, Epstein-Barr virus, and cytomegalovirus, in addition to the hepatotoxicity associated with several immunosuppressive agents (azathioprine, tacrolimus, and cyclo-sporine) [88]. However, hepatitis C virus infection has been demonstrated convincingly to be the primary cause of posttransplantation liver disease in renal allograft recipients [89,90].

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