Taniguchi Masahiko, Furukawa Hiroyuki, Shimamura Tsuyoshi, Suzuki Tomomi, Yamashita Kenichiro, Ota Minoru, Todo Satoru
Department of General Surgery, Graduate School of Medicine, Hokkaido University, Sapporo, Japan.
Transplantation. 2006 Jun 27;81(12):1747-9. doi: 10.1097/01.tp.0000226075.04938.43.
Double-filtration plasmapheresis (DFPP) selectively removes high molecular weight substances including hepatitis C virus (HCV). Four live donor liver transplantation (LDLT) recipients with HCV received combination therapy with low-dose interferon (IFN) and ribavirin with DFPP. Three patients underwent this therapy for prophylaxis of HCV recurrence, and one for treating fibrosing cholestatic hepatitis (FCH). The combination therapy and DFPP decreased HCV RNA levels to 8.2% +/- 2.9% and 0.7% +/- 0.5% by the 5th and 30th day of treatment, respectively. Three patients who underwent DFPP for prophylaxis showed no evidence of HCV recurrence for >1 year after treatment. The patient whose graft showed FCH, recovered dramatically after the DFPP treatment. DFPP appeared to be effective in reducing HCV viremia and preventing HCV recurrence in patients with high HCV RNA levels after LDLT. Moreover, it may become a rescue therapy for FCH in a liver transplant recipient with hepatitis C.
双重滤过血浆置换术（DFPP）可选择性清除包括丙型肝炎病毒（HCV）在内的高分子量物质。4例接受活体供肝肝移植（LDLT）的丙型肝炎病毒感染者接受了低剂量干扰素（IFN）联合利巴韦林及DFPP的联合治疗。3例患者接受该治疗以预防HCV复发，1例用于治疗纤维性胆汁淤积性肝炎（FCH）。联合治疗及DFPP分别在治疗第5天和第30天时将HCV RNA水平降至8.2%±2.9%和0.7%±0.5%。3例接受DFPP预防治疗的患者在治疗后1年以上未出现HCV复发迹象。移植肝出现FCH的患者在DFPP治疗后显著康复。DFPP似乎对降低LDLT后HCV RNA水平较高患者的HCV病毒血症及预防HCV复发有效。此外，它可能成为丙型肝炎肝移植受者FCH的挽救治疗方法。
