Effectiveness of combination therapy of splenectomy and long-term interferon in patients with hepatitis C virus-related cirrhosis and thrombocytopenia.
OBJECTIVE
To elucidate the effectiveness of combination therapy of splenectomy and long-term interferon (IFN) on survival and hepatocarcinogenesis, we retrospectively analyzed 180 patients with hepatitis C virus (HCV)-related cirrhosis and thrombocytopenia.


METHODS
Group A consisted of 121 patients who received neither splenectomy nor IFN therapy. Group B consisted of 11 patients who underwent splenectomy only. Group C consisted of 32 patients who underwent IFN therapy only. Group D consisted of 16 patients who received the combination therapy splenectomy followed by IFN therapy.


RESULTS
The viral response in group D estimated at least 6 months after IFN therapy showed sustained viral response in four patients, biochemical response in one and no response in six. Multivariate analysis using time-dependent variables showed significant improvement of survival rate in patients on the combination therapy,but no effect on the appearance rate of hepatocarcinogenesis relative to the findings in group A.


CONCLUSIONS
In this study, the splenectomy did not directly improve the prognosis, but increased the ability for patients to undergo IFN. As a result, we considered that the combination therapy of splenectomy and long-term IFN significantly improved survival rate in patients with advanced HCV-related cirrhosis and thrombocytopenia.
Morihara
Daisuke
D
Department of Hepatology, Toranomon Hospital, Tokyo, Japan.
Kobayashi
Masahiro
M
Ikeda
Kenji
K
Kawamura
Yusuke
Y
Saneto
Hiromi
H
Yatuji
Hiromi
H
Hosaka
Tetuya
T
Sezaki
Hitomi
H
Akuta
Norio
N
Suzuki
Yoshiyuki
Y
Suzuki
Fumitaka
F
Kumada
Hiromitu
H