caa a22 4500 445888903 CHVBK 20180317145609.0 cr unu---uuuuu 170323e20110801xx s 000 0 eng 10.1007/s00535-011-0407-9 doi (NATIONALLICENCE)springer-10.1007/s00535-011-0407-9 A retrospective cohort study of partial splenic embolization for antiviral therapy in chronic hepatitis C with thrombocytopenia [Elektronische Daten] [Hiroki Tahara, Hitoshi Takagi, Ken Sato, Yasushi Shimada, Hiroki Tojima, Tomoyuki Hirokawa, Tatsuya Ohyama, Katsuhiko Horiuchi, Atsushi Naganuma, Hirotaka Arai, Satoru Kakizaki, Masatomo Mori] Background: Although partial splenic embolization (PSE) is reportedly effective prior to interferon (IFN)-based therapy, the number of subjects in these studies is small, and the appropriate candidates and disease prognosis remain unknown. Methods: PSE was performed in 30 patients with advanced hepatitis C who could not receive IFN-based therapy because of thrombocytopenia, platelet counts of ≤100,000/mm3, and hypersplenism. Also, we compared 25 PSE-treated patients with 23 PSE-untreated patients with thrombocytopenia receiving pegylated IFN (PEG-IFN)-alpha 2b plus ribavirin over the same period. Results: PSE significantly increased platelet and leukocyte counts. PSE was well tolerated with no severe complications. All the patients could receive IFN-based therapy. Discontinuation of therapy in the total cohort of PSE-treated patients was not due to thrombocytopenia. Although PSE did not significantly increase the sustained virological response (SVR) rate, it significantly maintained higher platelet counts throughout the observation period and increased the percentage of patients with 100% adherence to PEG-IFN in the total controlled study population and in subjects with genotype 2. In PSE-treated patients with genotype 2, a trend towards increased SVR was noted. Four patients developed hepatocellular carcinoma (HCC) at a median of 14.5months after PSE, even though two of these patients had achieved an SVR. Conclusions: IFN-based therapy following PSE had an advantage in the maintenance of higher platelet counts, and PSE possibly caused an increase in adherence to PEG-IFN. Although patients with genotype 2 might be better candidates for PSE, further evaluation is needed. Careful follow-up of PSE-treated patients, even though they may have achieved an SVR, is needed to detect HCC. Springer, 2011 Partial splenic embolization nationallicence Chronic hepatitis C nationallicence Interferon nationallicence Ribavirin nationallicence Sustained virological response nationallicence Thrombocytopenia nationallicence CT : Computed tomography nationallicence HALT-C : Hepatitis C antiviral long-term treatment against cirrhosis nationallicence HCC : Hepatocellular carcinoma nationallicence HCV : Hepatitis C virus nationallicence IFN : Interferon nationallicence IL28B : Interleukin 28B nationallicence ISDR : IFN sensitivity-determining region nationallicence PEG-IFN : Pegylated IFN nationallicence PSE : Partial splenic embolization nationallicence r sp : Spearman rank correlation coefficient nationallicence SNPs : Single-nucleotide polymorphisms nationallicence SVR : Sustained virological response nationallicence Tahara Hiroki Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, 3-39-15 Showa-machi, 371-8511, Maebashi, Gunma, Japan aut Takagi Hitoshi Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, 3-39-15 Showa-machi, 371-8511, Maebashi, Gunma, Japan aut Sato Ken Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, 3-39-15 Showa-machi, 371-8511, Maebashi, Gunma, Japan aut Shimada Yasushi Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, 3-39-15 Showa-machi, 371-8511, Maebashi, Gunma, Japan aut Tojima Hiroki Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, 3-39-15 Showa-machi, 371-8511, Maebashi, Gunma, Japan aut Hirokawa Tomoyuki Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, 3-39-15 Showa-machi, 371-8511, Maebashi, Gunma, Japan aut Ohyama Tatsuya Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, 3-39-15 Showa-machi, 371-8511, Maebashi, Gunma, Japan aut Horiuchi Katsuhiko Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, 3-39-15 Showa-machi, 371-8511, Maebashi, Gunma, Japan aut Naganuma Atsushi Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, 3-39-15 Showa-machi, 371-8511, Maebashi, Gunma, Japan aut Arai Hirotaka Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, 3-39-15 Showa-machi, 371-8511, Maebashi, Gunma, Japan aut Kakizaki Satoru Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, 3-39-15 Showa-machi, 371-8511, Maebashi, Gunma, Japan aut Mori Masatomo Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, 3-39-15 Showa-machi, 371-8511, Maebashi, Gunma, Japan aut Journal of Gastroenterology Springer Japan 46/8(2011-08-01), 1010-1019 0944-1174 46:8<1010 2011 46 535 https://doi.org/10.1007/s00535-011-0407-9 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00535-011-0407-9 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Tahara Hiroki Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, 3-39-15 Showa-machi, 371-8511, Maebashi, Gunma, Japan aut NATIONALLICENCE 700 1- Takagi Hitoshi Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, 3-39-15 Showa-machi, 371-8511, Maebashi, Gunma, Japan aut NATIONALLICENCE 700 1- Sato Ken Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, 3-39-15 Showa-machi, 371-8511, Maebashi, Gunma, Japan aut NATIONALLICENCE 700 1- Shimada Yasushi Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, 3-39-15 Showa-machi, 371-8511, Maebashi, Gunma, Japan aut NATIONALLICENCE 700 1- Tojima Hiroki Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, 3-39-15 Showa-machi, 371-8511, Maebashi, Gunma, Japan aut NATIONALLICENCE 700 1- Hirokawa Tomoyuki Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, 3-39-15 Showa-machi, 371-8511, Maebashi, Gunma, Japan aut NATIONALLICENCE 700 1- Ohyama Tatsuya Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, 3-39-15 Showa-machi, 371-8511, Maebashi, Gunma, Japan aut NATIONALLICENCE 700 1- Horiuchi Katsuhiko Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, 3-39-15 Showa-machi, 371-8511, Maebashi, Gunma, Japan aut NATIONALLICENCE 700 1- Naganuma Atsushi Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, 3-39-15 Showa-machi, 371-8511, Maebashi, Gunma, Japan aut NATIONALLICENCE 700 1- Arai Hirotaka Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, 3-39-15 Showa-machi, 371-8511, Maebashi, Gunma, Japan aut NATIONALLICENCE 700 1- Kakizaki Satoru Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, 3-39-15 Showa-machi, 371-8511, Maebashi, Gunma, Japan aut NATIONALLICENCE 700 1- Mori Masatomo Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, 3-39-15 Showa-machi, 371-8511, Maebashi, Gunma, Japan aut NATIONALLICENCE 773 0- Journal of Gastroenterology Springer Japan 46/8(2011-08-01), 1010-1019 0944-1174 46:8<1010 2011 46 535 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer