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1)Artificial Organ & Transplantation Surgery, University of Tokyo îµ¨ 2006$103#626&630

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Table 1. 移植前抗ウイルス治療

Forns^9）

Everson^8）

Crippin^7）

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15 患者数

IFN＋ RBV IFN＋ RBV

IFN 治療法

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33 奏効率（%）

33 50

奏効した患者のうち移植後記載なしに再発した患者の割合（%）

IFN，インターフェロン； RBV，リバビリン

Table 2. C型肝炎再感染の危険因子ウイルス因子

高ウイルス価ジェノタイプ 1，4 クワドスピーシズ数インターフェロン無効患者因子

年齢人種 HLA一致

原発性肝細胞癌の合併（術前）

ドナー年齢脂肪肝阻血時間生体ドナー術後経過

ステロイドパルス療法，OKT3 急性拒絶反応

サイトメガロウイルス感染

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Table 3. ペグインターフェロン・リバビリン併用療法

駆除率治療

治療期間（月）

症例数出版年

著者治療後 6ヵ月

治療直後陰性持続リバビリン

（mg/day）

ペグインターフェロン

Not described 25%

400～ 600 1.5 μg/kg/w

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2004 Neff^10）

26%

37%

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2004 Rodriguez-Luna¹¹^）

Not described 38%

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55%

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2004 Dumortier¹³^）

12%

27%

Not described 180 μg

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2005 Chalasani¹⁴^）

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58%

400～ 800 1.5 μg/kg/w

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Figure 1. Ｃ型肝炎陽性症例に対する移植後予防療法の実際

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1'Kato T, Yoshida H, Safdar K, et al : Steroid-free induction and preemptive antiviral therapy for liver transplant recipients with hepatitis C : a pre- liminary report from a prospective randomized study. Transplant Proc 37 ; 1217%1219 : 2005 2'Brillanti S, Vivarelli M, De Ruvo N, et al : Slowly

tapering off steroids protects the graft against hepatitis C recurrence after liver transplantation.

Liver Transpl 8 ; 884%888 : 2002

3'Ghobrial RM, Steadman R, Gornbein J, et al : A 10- year experience of liver transplantation for hepatitis C : analysis of factors determining outcome in over 500 patients . Ann Surg 234 ; 384%393 : 2001

4'Machicao VI, Bonatti H, Krishna M, et al : Donor

age affect fibrosis progression and graft survival after liver transplantation for hepatitis C. Trans- plantation 77 ; 84%92 : 2004

5'Schiano TD , Gutierrez JA , Walewski JL , et al : Accelerated hepatitis C virus kinetics but similar survival rates in recipients of liver grafts from liv- ing versus deceased donors . Hepatology 42 ; 1420%1428 : 2005

6'Bizollon T , Ahmed SN , Radenne S , et al : Long term histological improvement and clearance of intrahepatic hepatitis C virus RNA following sustained response to interferon-ribavirin combination therapy in liver transplanted patients with hepatitis C virus recurrence . Gut 52 ; 283%287 : 2003

7'Crippin JS, McCashland T, Terrault N, et al : A pilot study of the tolerability and efficacy of antiviral therapy in hepatitis C virus-infected patients awaiting liver transplantation. Liver Transpl 8 ; 350%355 : 2002

8'Everson G , Trouillot T , Trotter J , et al : Treat- ment of decompensated cirrhosis with a low ac- celerating dose regimen of interferon-alpha 2 b plus ribavirin : safety and efficacy . Hepatology 32 ; 595A : 2001

9'Forns X , Garcia-Retortillo M , Serrano T , et al : Antiviral therapy of patients with decompensated cirrhosis to prevent recurrence of hepatitis C after liver transplantation. J Hepatol 39 ; 389% 396 : 2003

10'Neff GW, Montalbano M, OBrien CB, et al : Treat- ment of established recurrent hepatitis C in liver- transplant recipients with pegylated interferon- alfa-2b and ribavirin therapy. Transplantation 78 ; 1303%1307 : 2004

11'Rodriguez-Luna H , Khatib A , Sharma P , et al : Treatment of recurrent hepatitis C infection after liver transplantation with combination of pegylated interferon alpha 2 b and ribavirin : an open-label series . Transplantation 77 ; 190%194 : 2004

12'Ross AS, Bhan AK, Pascual M, et al : Pegylated interferon alpha-2 b plus ribavirin in the treatment of post-liver transplant recurrent hepatitis C. Clin Transplant 18 ; 166%173 : 2004

13'Dumortier J , Scoazec JY , Chevallier P , et al : Treatment of recurrent hepatitis C after liver transplantation : a pilot study of peginterferon alfa-2b and ribavirin combination. J Hepatol 40 ; 669%674 : 2004

14'Chalasani N , Manzarbeitia C , Ferenci P , et al : Pegasys Transplant Study Group. Peginterferon

|186e 629

&23'

(5)

alfa-2a for hepatitis C after liver transplantation : two randomized, controlled trials. Hepatology 41 ; 289"298 : 2005

15$Castells L, Vargas V, Allende H, et al : Esteban R, Guardia J. Combined treatment with pegylated interferon (alpha-2 b ) and ribavirin in the acute

phase of hepatitis C virus recurrence after liver transplantation. J Hepatol 43 ; 53"59 : 2005

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