Partial splenic embolization (PSE) or
splenectomy is widely performed to increase platelet counts for
interferon (IFN)
therapy. The aim of the present study was to evaluate the long-term effects of
splenectomy and subsequent IFN
therapy in patients with hepatitis C virus (HCV)-related
liver cirrhosis (LC). The present study included 19 patients with HCV-related LC who underwent
splenectomy for thrombo-
cytopenia caused by
hypersplenism. IFN
therapy was performed in all 19 patients. The effects of
splenectomy and subsequent IFN
therapy on peripheral blood counts, liver function,
carcinogenesis and survival rates were evaluated.
Splenectomy was safely performed in all patients without major complications with the exception of portal
thrombosis, which, however, it did not affect liver function when treated appropriately.
Thrombocytopenia improved and IFN
therapy could be performed in all the patients. A sustained virological response (SVR) was not observed in patients with genotype 1 although it was observed in 75% of patients with genotype 2. Due to severe side effects, five patients did not undergo scheduled IFN
therapy. Over 5 years, the mean platelet number increased from 5.2 x 10(4) to 16.8 x 10(4)/mm3 (P<0.01) and liver function improved following
splenectomy (
albumin, Alb: 3.5‑3.8 g/dl; total
bilirubin, T-Bil: 1.0‑0.7 mg/dl; prothrombin time, PT: 74.1‑97.7%; total
cholesterol; T-cho: 140‑168 mg/dl; P<0.05).
Hepatocellular carcinoma (HCC) occurred in only one patient during long‑term observation and follow‑up of the patients not presenting with HCC at entry. The results of the present study demonstrate that
splenectomy followed by
interferon therapy could be beneficial in patients with HCV-related LC.