Treatment modalities for hypersplenism in liver transplant recipients with recurrent hepatitis C.
Hepatitis C is the most common indication for orthotopic liver transplantation in the United States. Unfortunately, hepatitis C recurs universally in the transplanted liver and is the major cause of decreased graft and patient survival. The combination therapy of interferon and ribavirin has been shown to be the most effective therapy for recurrent hepatitis C. However, pre- and post-transplant hypersplenism often precludes patients from receiving the antiviral therapy. Splenectomy and partial splenic embolization are the two invasive modalities that can correct the cytopenia associated with hypersplenism. In this report we review the two treatment options, their associated outcomes and complications.
Division of Transplant Surgery, Department of Transplantation, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224, United States.
Lena
L
Sibulesky
Justin-H
JH
Nguyen
Ricardo
R
Paz-Fumagalli
C-Burcin
CB
Taner
Rolland-C
RC
Dickson
D004621:Embolization, Therapeutic / Q000379:methods; D006085:Graft Survival; D006526:Hepatitis C / Q000503:physiopathology* / Q000628:therapy*; D006801:Humans; D006971:Hypersplenism / Q000628:therapy*; D007970:Leukopenia / Q000628:therapy; D016031:Liver Transplantation / Q000009:adverse effects / Q000379:methods*; D012008:Recurrence; D013154:Spleen / Q000378:metabolism; D013156:Splenectomy / Q000379:methods; D013921:Thrombocytopenia / Q000628:therapy; D016896:Treatment Outcome