A retrospective study of renal allografted patients revealed that the incidence of azathioprine (Imuran)-induced leukopenia in nonsplenectomized patients was significantly higher than in patients splenectomized prior to transplantation. In two patients whose case histories are presented, there was a marked increase in tolerance to azathioprine when splenectomy was performed for leukopenia after transplantation.
Woods JE, DeWeerd JH, Johnson WJ, Anderson CF. Splenectomy in Renal Transplantation: Influence on Azathioprine Sensitivity. JAMA. 1971;218(9):1430–1431. doi:10.1001/jama.1971.03190220048016
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