An evaluation of the hepatic dysfunction which occurred in the post-transplant period in 31 of 82 renal transplant recipients managed at Parkland Memorial Hospital has revealed three different patterns of liver disease. Two patients died in acute liver failure during an acute fulminant illness. Eight other patients suffered an acute, anicteric, and completely reversible hepatic disorder. Twenty-one patients have been afflicted with a chronic form of liver disease which, in a least 5, has progressed to an active cirrhosis. Infection with cytomegalovirus and other viruses is probably responsible for most of the liver disease we have observed in these patients, while hepatotoxicity related to therapy with azathioprine and other drugs has played only a minor role.
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