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Fibrosing cholestatic hepatitis with hepatitis C virus treated by double filtration plasmapheresis and interferon plus ribavirin after liver transplantation

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Abstract

Fibrosing cholestatic hepatitis (FCH) is a serious disease in patients with recurrent hepatitis C after liver transplantation (LTx). Antiviral therapy is indicated in these patients; however, it is not always effective, and the prognosis of FCH is generally poor. Double filtration plasmapheresis (DFPP) has been shown to be effective at eliminating hepatitis C virus (HCV) in patients with chronic hepatitis C. We report a case of FCH with severe cholestasis (total bilirubin 34.2 mg/dl) after LTx. Combination therapy with interferon (IFN) and ribavirin (RBV) was unsuccessful for improving cholestasis; however, the addition of DFPP to IFN and RBV alleviated cholestasis and improved renal function. Although IFN and RBV with DFPP could not eliminate HCV, results of liver function tests improved and remained stable for several months. This treatment with DFPP combined with IFN and RBV would be useful for resolving cholestasis due to FCH. Moreover, treatment of DFPP could improve liver and renal function test results and could stop the worsening condition of patients with FCH.

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Acknowledgment

We thank Dr. Hironori Haga (Department of Pathology, Kyoto University Graduate School of Medicine, Kyoto, Japan) for the histological diagnosis.

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Authors and Affiliations

  1. Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon, Ehime, 791-0295, Japan

    Teruki Miyake, Kojiro Michitaka, Yoshio Tokumoto, Shinya Furukawa, Teruhisa Ueda, Yoshiko Soga, Masanori Abe, Bunzo Matsuura, Yoichi Hiasa & Morikazu Onji

  2. Department of Organ Regulatory Surgery, Ehime University Graduate School of Medicine, Toon, Ehime, Japan

    Taro Nakamura, Taiji Tohyama & Nobuaki Kobayashi

Authors
  1. Teruki Miyake
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  2. Kojiro Michitaka
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  3. Yoshio Tokumoto
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  5. Teruhisa Ueda
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  6. Yoshiko Soga
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  12. Yoichi Hiasa
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  13. Morikazu Onji
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Corresponding author

Correspondence to Yoichi Hiasa.

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Miyake, T., Michitaka, K., Tokumoto, Y. et al. Fibrosing cholestatic hepatitis with hepatitis C virus treated by double filtration plasmapheresis and interferon plus ribavirin after liver transplantation. Clin J Gastroenterol 2, 125–130 (2009). https://doi.org/10.1007/s12328-008-0057-5

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  • DOI: https://doi.org/10.1007/s12328-008-0057-5

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