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Splenectomy and preemptive interferon therapy for hepatitis C patients after living‐donor liver transplantation
Author(s) -
Kishi Yoji,
Sugawara Yasuhiko,
Akamatsu Nobuhisa,
Kaneko Junichi,
Tamura Sumihito,
Kokudo Norihiro,
Makuuchi Masatoshi
Publication year - 2005
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/j.1399-0012.2005.00419.x
Subject(s) - medicine , splenectomy , liver transplantation , discontinuation , cytopenia , hepatitis c , transplantation , gastroenterology , ribavirin , cirrhosis , surgery , hepatitis , hepatitis b , immunology , hepatitis c virus , spleen , bone marrow , virus
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.