Clinicopathological factors to determine the prognosis and clinical efficacy of plasma exchange in primary biliary cirrhosis.

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We clinicopathologically investigated the prognosis and treatment in 15 patients with symptomatic primary biliary cirrhosis. Although there was no correlation between the survival period after the serum level of total bilirubin first exceeded 3mg/dl and various pathological factors, upper gastrointestinal (UGI) hemorrhage was found in 9 of dead 11 cases, and all of 9 died in a short time after hemorrhage. Therefore it was suggested that the prevention and treatment for UGI hemorrhage might be important as a factor to determine the prognosis.<BR>The mean survival period of cases positively treated with plasma exchange (PE), esophageal transection, endoscopic injection sclerotherapy for esophageal varices, and so on was 47.8±9.0 months, which was significantly longer than that of non-treated cases: 17.4±5.0 months. Each survival period of alive 4 cases positively treated ranges from 23 to 60 months now.<BR>Concerning with methods of PE, we compared double filtration with single filtration. Changes of laboratory data in both methods were not so different. Therefore it was suggested that double filtration might be more desirable as far as possible in consideration of the prevention against side effects.
社団法人日本肝臓学会の論文