Clinical Gastroenterology Vol.28 No.9(8)

Theme Liver Transplantation -- Current Status and Perspective
Title Liver Transplantation as Chronic Hepatitis C and Liver Cirrhosis Treatment
Publish Date 2013/08
Author Shohei Yoshiya Department of Surgery and Science, Graduate School of Medical Sciences, Kyusyu University
Author Ken Shirabe Department of Surgery and Science, Graduate School of Medical Sciences, Kyusyu University
Author Mizuki Ninomiya Department of Surgery and Science, Graduate School of Medical Sciences, Kyusyu University
Author Yo-ichi Yamashita Department of Surgery and Science, Graduate School of Medical Sciences, Kyusyu University
Author Toru Ikegami Department of Surgery and Science, Graduate School of Medical Sciences, Kyusyu University
Author Tomoharu Yoshizumi Department of Surgery and Science, Graduate School of Medical Sciences, Kyusyu University
Author Yuji Soejima Department of Surgery and Science, Graduate School of Medical Sciences, Kyusyu University
Author Yoshihiko Maehara Department of Surgery and Science, Graduate School of Medical Sciences, Kyusyu University
[ Summary ] Chronic hepatitis C and related liver cirrhosis are the primary indications for liver transplantation. Liver cirrhosis recipients who have hepatitis C have worse postoperative prognoses than those with other deseases, for two main reasons. First, there is difficulty in choosing an appropriate time to perform transplants because the condition of recipients with low bilirubin values may rapidly worsen due to hepatocellular failure. Second, most graft experience posttransplant relapses due to hepatitis C. Improving postoperative prognoses is possible by choosing suitable transplant timing and making improvements in interferon therapy. We strive to improve interferon therapy outcomes in the following ways : 1) low dose induction for interferon therapy, 2) the simultaneous splenectomies during transplantation, and 3) the interferon conversion therapy, changing from interferon α-2b to interferon α-2a, 4) predictions on the outcomes of interferon therapy may be made with gene analysis. The introduction of novel medicines will lead to further improvements in transplantation outcomes for hepatitis C patients.
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