mTOR inhibitor reduces nontumour-related death in liver transplantation for hepatocellular carcinoma.
Mol Biomed
; 5(1): 9, 2024 03 10.
Article
en En
| MEDLINE
| ID: mdl-38461206
ABSTRACT
Sirolimus is a regularly applied immunosuppressant for patients undergoing liver transplantation (LT) for hepatocellular carcinoma (HCC). Sirolimus not only significantly inhibits HCC recurrence but also protects renal function. However, the improvement effect of sirolimus on nontumour-related death in patients is still unknown. The aim of our study was to investigate the therapeutic effect of sirolimus on nontumour-related deaths. In this study, we retrospectively enrolled 403 LT patients with HCC from January 1, 2015, to December 31, 2018. The median follow-up time was 47.1 months. The patients were divided into the sirolimus group (N = 184) and the sirolimus-free group (N = 219). There were no significant differences between the sirolimus group and the sirolimus-free group in survival (P = 0.054). In transplant patients who exceeded the Milan or Hangzhou criteria, the sirolimus group achieved higher survival than the sirolimus-free group (P = 0.005; P = 0.02). Moreover, multivariate analysis showed that sirolimus strongly reduced the hazard ratio (HR) for nontumour-related death in LT patients who exceeded the Milan (HR 0.42; 95% CI 0.18-1; P = 0.05) or Hangzhou criteria (HR 0.26; 95% CI 0.08-0.89; P = 0.032). HCC recurrence increased the risk of nontumour-related death. In conclusion, sirolimus-based immunosuppression can significantly reduce nontumour-related death in LT patients who exceed the criteria for transplantation. In addition, this finding will further promote the application of sirolimus after liver transplantation for hepatocellular carcinoma.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
6_ODS3_enfermedades_notrasmisibles
Problema de salud:
6_liver_cancer
Asunto principal:
Trasplante de Hígado
/
Carcinoma Hepatocelular
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Sirolimus
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Serina-Treonina Quinasas TOR
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Neoplasias Hepáticas
Límite:
Adult
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Female
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Humans
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Male
Idioma:
En
Revista:
Mol Biomed
Año:
2024
Tipo del documento:
Article
País de afiliación:
China