Effect of different immunosuppressive schedules on recurrence-free survival after liver transplantation for hepatocellular carcinoma

Transplantation
M VivarelliA D Pinna

Abstract

Tumor recurrence represents the main limitation of liver transplantation in patients with hepatocellular carcinoma (HCC) and can be favored by exposure to calcineurin inhibitors. We investigated the effect of an immunosuppressant schedule that minimizes the exposure to calcineurin inhibitors on patients transplanted for HCC to ascertain whether this can reduce the tumor recurrence rate. For this purpose, we conducted a matched-cohort study: 31 patients with HCC transplanted between 2004 and 2007 who received sirolimus as part of their immunosuppression (group A) were compared with a control group of 31 patients (group B) transplanted in the same period who had the same prognostic factors but were given standard immunosuppression based on tacrolimus. Three-year recurrence-free survival was 86% in group A and 56% in group B (P=0.04). Although the prevalence of microvascular invasion G3-G4 grading and alpha-fetoprotein more than 200 ng/mL was identical in the two groups, exposure to tacrolimus was significantly higher in patients of group B (median, 8.54; range, 5.5-13.5) in comparison with those of group A (median, 4.6; range, 1.8-9.1) (P=0.0001). By using sirolimus, exposure to calcineurin inhibitors can be minimized, reducing t...Continue Reading

References

Mar 14, 1996·The New England Journal of Medicine·V MazzaferroL Gennari
May 7, 2002·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Nestor F EsnaolaJ Nicolas Vauthey
Jan 28, 2004·Annals of Surgery·Umberto CilloDavide Francesco D'Amico
Mar 12, 2004·Clinical Cancer Research : an Official Journal of the American Association for Cancer Research·Michelangelo FiorentinoAntonia D'Errico-Grigioni
Jun 30, 2004·Transplantation·Markus GubaEdward K Geissler
Apr 20, 2005·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Marco VivarelliAntonio Daniele Pinna
Apr 1, 2006·Transplant International : Official Journal of the European Society for Organ Transplantation·Gunnar SöderdahlBo-Göran Ericzon
Sep 5, 2006·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Richard B FreemanErick Edwards
Oct 31, 2007·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Vincenzo Mazzaferro

❮ Previous
Next ❯

Citations

Dec 1, 2012·HPB Surgery : a World Journal of Hepatic, Pancreatic and Biliary Surgery·Shirin Elizabeth Khorsandi, Nigel Heaton
Dec 8, 2011·World Journal of Gastroenterology : WJG·Marco Vivarelli, Andrea Risaliti
Jan 11, 2014·World Journal of Gastroenterology : WJG·Matteo CesconAntonio Daniele Pinna
Apr 2, 2014·Current Opinion in Organ Transplantation·Manuel Rodríguez-PerálvarezAndrew K Burroughs
Jul 9, 2013·Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen·M GubaC Bruns
May 2, 2013·Journal of Clinical Gastroenterology·Brett E FortuneSukru Emre
Apr 7, 2015·Journal of the Formosan Medical Association = Taiwan Yi Zhi·Kuo-Hsin ChenMeng-Kun Tsai
Aug 1, 2012·Seminars in Oncology·Emmanuel MelloulPierre-Alain Clavien
Aug 21, 2012·Transplantation Reviews·Josep M CampistolUNKNOWN ATOS Working Group
Feb 10, 2012·The Journal of Surgical Research·Alwine KistGreg J Barritt
Apr 14, 2011·Transplantation Proceedings·J F CastroagudínE Varo-Pérez
Sep 22, 2012·Transplant International : Official Journal of the European Society for Organ Transplantation·Martin-Walter WelkerJoerg Trojan
Jul 29, 2011·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Jan LerutRobert J Porte
Jan 19, 2011·Liver International : Official Journal of the International Association for the Study of the Liver·Jacques Belghiti, François Durand
Feb 27, 2013·Clinical Transplantation·Mélanie VallinJean-Yves Scoazec
Mar 9, 2011·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Faouzi SalibaJérome Dumortier
Jun 15, 2011·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·A CucchettiA D Pinna
Aug 14, 2012·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·P De SimoneUNKNOWN H2304 Study Group
Sep 21, 2011·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Carlos Gomez-MartinBruno Sangro
Oct 4, 2011·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Wenhua LiangXiaoshun He
Apr 21, 2011·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Hans J SchlittJames F Trotter
Jun 20, 2014·Transplant International : Official Journal of the European Society for Organ Transplantation·Evangelos CholongitasPatrizia Burra
Jun 15, 2015·Transplantation Reviews·Christophe Duvoux, Christian Toso
Aug 16, 2011·Transplantation Proceedings·J F CastroagudínE Varo
Jul 26, 2011·Journal of Hepatology·Toshiyasu KawaharaNorman M Kneteman
Jul 26, 2011·Journal of Hepatology·Greg J McKenna, James F Trotter
Jun 19, 2013·Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver·Luigi BolondiPierluigi Toniutto
Feb 9, 2016·Clinical Transplantation·Kerstin HerzerMartina Sterneck
Jan 6, 2017·Nature Reviews. Gastroenterology & Hepatology·Gonzalo Sapisochin, Jordi Bruix
Feb 16, 2017·Liver International : Official Journal of the International Association for the Study of the Liver·Charlotte E CostentinUNKNOWN Liver Transplantation French Study Group
Mar 21, 2018·Journal of Investigative Surgery : the Official Journal of the Academy of Surgical Research·Zhi-Hua ZhangQiang He
May 3, 2016·World Journal of Hepatology·Pavan Kedar MukthinuthalapatiMarwan Ghabril
Feb 28, 2019·Alimentary Pharmacology & Therapeutics·Georg WiltbergerMoritz Schmelzle
Apr 14, 2015·World Journal of Hepatology·Marta Guerrero-MisasManuel De la Mata
Nov 21, 2018·Journal of Investigative Surgery : the Official Journal of the Academy of Surgical Research·Sam GriggNeville Yeomans

❮ Previous
Next ❯

Related Concepts

Related Feeds

Carcinoma, Hepatocellular

Hepatocellular Carcinoma is a malignant cancer in liver epithelial cells. Discover the latest research on Hepatocellular Carcinoma here.

Adrenocortical Carcinoma

Hepatocellular carcinoma is the most common type of primary liver cancer and frequently occurs in individuals with chronic liver diseases like cirrhosis. Here is the latest research.

Related Papers

Hepatology : Official Journal of the American Association for the Study of Liver Diseases
C TosoNorman M Kneteman
Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society
Srinath ChinnakotlaGöran B Klintmalm
Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society
Michael A ZimmermanIgal Kam
© 2021 Meta ULC. All rights reserved