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©2009 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Oct 28, 2009; 15(40): 5010-5013
Published online Oct 28, 2009. doi: 10.3748/wjg.15.5010
Published online Oct 28, 2009. doi: 10.3748/wjg.15.5010
Treatment modalities for hypersplenism in liver transplant recipients with recurrent hepatitis C
Lena Sibulesky, Justin H Nguyen, Ricardo Paz-Fumagalli, C Burcin Taner, Rolland C Dickson, Division of Transplant Surgery and Transplant Hepatology, Division of Interventional Radiology, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224, United States
Author contributions: Sibulesky L wrote and revised the paper; Nguyen JH designed the study and participated in writing and revising the manuscript; Paz-Fumagalli R and Dickson RC participated in the design and revising the paper; Taner CB participated in writing and revising the paper.
Correspondence to: Justin H Nguyen, MD, Division of Transplant Surgery, Department of Transplantation, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224, United States. nguyen.justin@mayo.edu
Telephone: +1-904-9563261 Fax: +1-904-9563359
Received: March 13, 2009
Revised: September 23, 2009
Accepted: September 30, 2009
Published online: October 28, 2009
Revised: September 23, 2009
Accepted: September 30, 2009
Published online: October 28, 2009
Abstract
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.