Effects of double-filtration plasmapheresis combined with interferon plus ribavirin for recurrent hepatitis C after living donor liver transplantation.

Response rates to interferon and ribavirin treatment for recipients with recurrent hepatitis C virus (HCV) infection are suboptimal, particularly for those with genotype 1b and high viral load. The present study evaluated the effects of combining double-filtration plasmapheresis (DFPP) with pharmacotherapy using interferon plus ribavirin after living donor liver transplantation. DFPP was applied in the first week to mechanically eliminate HCV from the blood in the induction phase. One patient could not tolerate DFPP, and another 2 patients discontinued interferon treatment because of adverse effects. Negative results were obtained for HCV-RNA in week 48 (end-treatment response) in 3 patients, and sustained virological response (SVR) was achieved in 2 patients (20%). These response rates were not improved compared to those of the historical non-DFPP group. Although this preliminary study examined only a small number of patients, no additive effect of DFPP was observed in terms of the SVR rate.