Long-term evaluation of partial splenic embolization followed by interferon therapy in patients with hepatitis C virus (HCV) cirrhosis and thrombocytopenia.

作者: Hirohito Shimizu , Kentaro Takatsuka , Hiroyasu Nakano , Takanori Tenjin , Tomoaki Fujikawa

DOI: 10.2169/INTERNALMEDICINE.53.1842

关键词: Internal medicineHepatitis CCirrhosisGastroenterologyHepatocellular carcinomaSurgerySplenectomyMedicineHemodynamicsPlateletSerotypeHepatitis C virus

摘要: OBJECTIVE Patients with hepatitis C virus (HCV) cirrhosis and thrombocytopenia are often excluded from receiving interferon therapy because the treatment results in severe platelet depletion. Surgical splenectomy or partial splenic embolization (PSE) is a promising procedure for increasing count before therapy. We performed PSE evaluated long-term clinical course HCV cirrhotic patients. METHODS were included (n=108) this study. The straight-coiled (Takatsuka method) was performed. count, hemodynamic changes, rate of sustained virological response (SVR) prevalence hepatocellular carcinoma (HCC) evaluated. RESULTS resulted significant increase (before PSE: 7.9±2.3×10(4)/μL, two weeks after 16.7±6.6×10(4)/μL (p<0.001). Therefore, all participants started on regular-dose SVR 24% serotype 1 62% 2. In biochemical responders (BR) SVR, overall survival 94.6% over five years 89.3% 10 years. non-responders (NR), 78.7% 62.2% patients SVR+BR significantly higher than that observed NR (p=0.0082). There no differences HCC between NR. CONCLUSION enabled induction thrombocytopenia. Although did not differ patients, there benefit SVR+BR.

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