Partial splenic embolization as pretreatment for antiviral therapy in hepatitis C virus infection

Pålsson, Birger; Verbaan, Hans

doi:10.1097/00042737-200511000-00001

Cited by 26 publications

(28 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The significant increase of WBC and RBC counts in the portal hypertension group is related not only to the elimination of spleen retention, but also to the elimination of hypersplenism [10][11][12]. In patients with portal hypertension, the increased number of macrophages in the enlarged spleen leads to enhanced phagocytosis and destruction of blood cells [13,14].…”

Section: Changes In Blood Cells and The Causesmentioning

confidence: 97%

Peripheral Blood Cells Changes After Two Groups of Splenectomy and Prevention and Treatment of Postoperative Complication

Lv¹,

Gong²,

Han³

et al. 2018

J Hypertens

View full text Add to dashboard Cite

Objective: This study aimed to investigate the changes in peripheral blood cells after two groups of splenectomy in patients with traumatic rupture of the spleen and portal hypertension group, as well as causes and prevention and treatment of splenectomy related portal vein thrombosis. Methods:Clinical data from 109 patients with traumatic rupture of the spleen who underwent splenectomy in our hospital from January 2001 to August 2015 were retrospectively analyzed, and compared with those from 240 patients with splenomegaly due to cirrhotic portal hypertension who underwent splenectomy over the same period.Results: After splenectomy, peripheral platelet (PLT) count was significantly increased in both groups (P<0.01), and the increase was significantly greater in the traumatic rupture group than in the portal hypertension group (P<0.05). The red blood cell (RBC) count remained unchanged (P>0.05), while the white blood cell (WBC) count was significantly decreased (P<0.05) in the traumatic rupture group. Both WBC and RBC counts were increased significantly (P<0.05) in the portal hypertension group. Both groups received routine anticoagulant therapy after splenectomy. The incidence of portal vein thrombosis was 8.26% and 6.67% in the traumatic rupture and portal hypertension groups (P>0.05), respectively, which was alleviated with urokinase. Conclusion:The significant increase of peripheral PLT count in both groups after splenectomy might be caused by the removal of the site that stored blood cells. The more significant increase of PLT in the traumatic rupture group might be related to a constant production and release of thrombopoietin by the normal liver into blood circulation. The lack of increase of RBC count in the traumatic rupture group indicated no storage of RBCs in the spleen, and the significant increase of WBC count was related to the control of inflammation. The significant increase of WBC and RBC counts in the portal hypertension group was related not only to the elimination of spleen storage, but also to the elimination of hypersplenism. Postoperative routine anticoagulant and thrombolytic therapy could prevent and treat portal vein thrombosis.

show abstract

Section: Changes In Blood Cells and The Causesmentioning

confidence: 97%

Peripheral Blood Cells Changes After Two Groups of Splenectomy and Prevention and Treatment of Postoperative Complication

Lv¹,

Gong²,

Han³

et al. 2018

J Hypertens

View full text Add to dashboard Cite

show abstract

“…Although there have been similar reports of splenic embolization for interferon therapy, prolonged high fever and pain due to massive splenic infarction are the most common unpleasant side effects after splenic embolization [13]. In contrast, surgical splenectomy renders patients free from such annoying complications.…”

Section: Pse Splenectomymentioning

confidence: 99%

Overwhelming Postsplenectomy Infection for Splenectomized HCV Patients

Hashimoto¹

2015

OALib

View full text Add to dashboard Cite

Pegylated-interferon (IFN) plus ribavirin remains the most effective therapeutic regimen for patients with chronic hepatitis C interferon. Thrombocytopenia is a common side effect of this treatment, often leading to discontinuation of a potentially curative therapy. Splenectomy was a clinically effective treatment for hepatitis C virus-associated thrombocytopenia. Splenectomy in patients with hepatitis C cirrhosis is now safer prelude to antiviral treatment. Overwhelming post splenectomy infection (OPSI) syndrome is a rare condition, but is associated with high mortality. However, recognition and clinical management of OPSI is not well established. We reviewed the literature characterizing the clinicopathological features of OPSI and assessed the most effective and feasible administration of the condition. Prevention strategies such as vaccination and education are also potentially important parts of the strategy for splenectomized HCV patients.

show abstract

“…Recently, treatments such as partial splenic arterial embolization (PSE) and surgical splenectomy have attempted to correct splenomegaly-associated thrombocytopenia [8,9,10,11,12,13,14,15,16,17,18] because the only current tool that improves thrombocytopenia is the administration of platelet infusions [19]. Sufficient increases in platelet counts are achieved in most patients following either PSE or surgical splenectomy [8,9,10,11,12,13,14,15,16,17,18,20], whereas clinical relapses into thrombocytopenia have occurred in several patients, especially those exhibiting PSE [12,20,21], and these relapses were mainly associated with insufficient infarcted spleen volumes [12,21,22].…”

Section: Introductionmentioning

confidence: 99%

“…Sufficient increases in platelet counts are achieved in most patients following either PSE or surgical splenectomy [8,9,10,11,12,13,14,15,16,17,18,20], whereas clinical relapses into thrombocytopenia have occurred in several patients, especially those exhibiting PSE [12,20,21], and these relapses were mainly associated with insufficient infarcted spleen volumes [12,21,22]. Those patients exhibiting relapsed thrombocytopenia thus require either dose reduction or treatment discontinuation, and these patients subsequently experience difficulties in eradicating HCV and also require additional treatments for thrombocytopenia.…”

Section: Introductionmentioning

confidence: 99%

Value of Laparoscopic Splenectomy as Salvage Treatment for Relapsed Thrombocytopenia after Partial Splenic Arterial Embolization

et al. 2010

View full text Add to dashboard Cite

Background/Aims: Recently, partial splenic arterial embolization (PSE) has become a supportive intervention for cirrhotic patients with hypersplenism in the administration of interferon therapy. However, relapsed thrombocytopenia is often observed in patients following PSE. This study aimed to report the clinical efficiency of laparoscopic splenectomy as a salvage treatment for relapsed thrombocytopenia following PSE. Methods: From 2005 to 2009, 6 patients with prior PSE treatment underwent laparoscopic splenectomy. We reviewed the surgical method of laparoscopic splenectomy and the peri- and postoperative outcomes. Results: Laparoscopic splenectomy effectively provided sufficient increases in patient platelet counts. In all patients, laparoscopic splenectomy was performed safely with no significant complications despite PSE-associated dense adhesion to the diaphragm and/or retroperitoneal attachments. Conclusion: Laparoscopic splenectomy provides a sufficient increase in patient platelet counts in relapsed thrombocytopenia following PSE. Therefore, laparoscopic splenectomy appears to be a superior supportive therapy for the treatment of thrombocytopenia in cirrhotic patients.

show abstract

Partial splenic embolization as pretreatment for antiviral therapy in hepatitis C virus infection

Cited by 26 publications

References 15 publications

Peripheral Blood Cells Changes After Two Groups of Splenectomy and Prevention and Treatment of Postoperative Complication

Peripheral Blood Cells Changes After Two Groups of Splenectomy and Prevention and Treatment of Postoperative Complication

Overwhelming Postsplenectomy Infection for Splenectomized HCV Patients

Value of Laparoscopic Splenectomy as Salvage Treatment for Relapsed Thrombocytopenia after Partial Splenic Arterial Embolization

Contact Info

Product

Resources

About