Splenectomy and preemptive interferon therapy for hepatitis C patients after living-donor liver transplantation.
Recurrent hepatitis C after liver transplantation is a major cause of graft failure. We routinely perform preemptive interferon and ribavirin therapy in patients after living-donor liver transplantation indicated for hepatitis C-related cirrhosis. One of the obstacles for the therapy includes blood cytopenia. To overcome this problem, we recently performed splenectomy concurrently with liver transplantation. Thirty-five patients underwent liver transplantation and received preemptive therapy for hepatitis C. They were divided into two groups: those with splenectomy (group A, n = 21) and those without (group B, n = 14). There was no significant difference in the frequency of morbidity between the groups. Platelet counts were well maintained in group A patients during the therapy, and cytopenia led to the discontinuation of the therapy in one group B patient. The results of the preliminary study warrant a randomized control trial to examine the feasibility of splenectomy and preemptive viral therapy during liver transplantation for hepatitis C.
Kishi
Yoji
Y
Artificial Organ and Transplantation Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, Bunkyo-ku, Tokyo, Japan.
Sugawara
Yasuhiko
Y
Akamatsu
Nobuhisa
N
Kaneko
Junichi
J
Tamura
Sumihito
S
Kokudo
Norihiro
N
Makuuchi
Masatoshi
M
D000998:Antiviral Agents / Q000627:therapeutic use; D005240:Feasibility Studies; D006526:Hepatitis C / Q000517:prevention & control*; D006801:Humans; D007372:Interferons / Q000627:therapeutic use; D016031:Liver Transplantation; D019520:Living Donors; D010865:Pilot Projects; D010976:Platelet Count; D012008:Recurrence; D012254:Ribavirin / Q000627:therapeutic use; D013156:Splenectomy
D000998:Antiviral Agents; D012254:Ribavirin; D007372:Interferons