Reduced calcineurin inhibitor exposure with antibody induction and recurrent hepatocellular carcinoma after liver transplantation

Abrahamsson, Jenny; Eilard, Malin Sternby; Rizell, Magnus; Bennett, William M.; Åberg, Fredrik

doi:10.1080/00365521.2021.2010799

Cited by 5 publications

(2 citation statements)

References 27 publications

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“…The only difference in immunosuppression management was represented by a more deliberate use of induction therapy with basiliximab in the D-HOPE group. However, conflicting results have been reported regarding a potential influence of induction by basiliximab on HCC recurrence after liver transplantation [ 80 , 81 ], and these have not been confirmed in the setting of a randomized trial. D-HOPE-treated grafts were procured from older donors with higher BMI, reflecting the preferential allocation of grafts from ECD to D-HOPE group.…”

Section: Discussionmentioning

confidence: 99%

Impact of Hypothermic Oxygenated Machine Perfusion on Hepatocellular Carcinoma Recurrence after Liver Transplantation

Rigo

Stefano

Patrono

et al. 2023

JPM

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Background: Machine perfusion may be able to mitigate ischemia-reperfusion injury (IRI), which increases hepatocellular carcinoma (HCC) recurrence after liver transplantation (LT). This study aimed to investigate the impact of dual-hypothermic oxygenated machine perfusion (D-HOPE) on HCC recurrence in LT. Methods: A single-center retrospective study was conducted from 2016 to 2020. Pre- and postoperative data of HCC patients undergoing LT were analyzed. Recipients of a D-HOPE-treated graft were compared to those of livers preserved using static cold storage (SCS). The primary endpoint was recurrence-free survival (RFS). Results: Of 326 patients, 246 received an SCS-preserved liver and 80 received a D-HOPE-treated graft (donation after brain death (DBD), n = 66; donation after circulatory death (DCD), n = 14). Donors of D-HOPE-treated grafts were older and had higher BMI. All DCD donors were treated by normothermic regional perfusion and D-HOPE. The groups were comparable in terms of HCC features and estimated 5-year RFS according to the Metroticket 2.0 model. D-HOPE did not reduce HCC recurrence (D-HOPE 10%; SCS 8.9%; p = 0.95), which was confirmed using Bayesian model averaging and inverse probability of treatment weighting-adjusted RFS analysis. Postoperative outcomes were comparable between groups, except for lower AST and ALT peak in the D-HOPE group. Conclusions: In this single-center study, D-HOPE did not reduce HCC recurrence but allowed utilizing livers from extended criteria donors with comparable outcomes, improving access to LT for patients suffering from HCC.

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Section: Discussionmentioning

confidence: 99%

Impact of Hypothermic Oxygenated Machine Perfusion on Hepatocellular Carcinoma Recurrence after Liver Transplantation

Rigo

Stefano

Patrono

et al. 2023

JPM

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“…However, its use also reduced tacrolimus exposure in MC-out patients, probably explaining a lower recurrence risk in this subcohort. 11 Conversely, a Korean study (N = 93) reported that the same induction therapy raised the recurrence rate within the first post-LT year in high-risk (ie, MC-out) patients. 12 A French multicentric study (N = 412) showed that antilymphocytic or anti-CD3 antibodies were an independent risk factor for recurrence ( P = 0.005).…”

mentioning

confidence: 98%

Comments on: Induction Immunosuppression Does Not Worsen Tumor Recurrence After Liver Transplantation for Hepatocellular Carcinoma

Lerut

Lai

2023

Transplantation

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Immunotherapy for hepatocellular carcinoma in liver transplant patients (Literature review)

Dzhanyan,

Novruzbekov,

Olisov

et al. 2023

vmirvz

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Hepatocellular carcinoma (HCC) is the third cause of cancer-related mortality worldwide, accounting for more than 800,000 deaths annually. Surgical removal of the neoplasm remains the most effective treatment option. Partial liver resection is an adequate solution for patients without cirrhosis or with well-compensated cirrhosis, orthotopic liver transplantation is necessary in patients with early stage HCC on the background of cirrhosis. Tumor recurrence remains a major limitation of long-term survival of patients after liver transplantation. Posttransplant immunosuppression reduces the body's antitumor defense, which is provided by natural immunity. This contributes to the development and progression of the tumor process. Purpose of the study: to analyze domestic and foreign publications that present treatment options for HCC recurrence after liver transplantation. Literature sources were searched in PubMed, Scopus, Web of Science, MEDLINE, eLibrary databases. The search was conducted in Russian and English by keywords: hepatocellular carcinoma, tyrosine kinase inhibitors, immune checkpoint inhibitors, therapy of HCC relapse, orthotopic liver transplantation, RETREAT index, regorafenib, nivolumab. The authors presented a review of the data on the use of tyrosine kinase inhibitors and immune checkpoint inhibitors to prevent HCC recurrence. The results of the analysis of literature sources showed that the issue of post-transplant immunosuppression is relevant. The large number of studies and clinical case reviews leaves hope that an effective way of immunosuppression for recurrent HCC patients after liver transplantation will soon be found.

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Reduced calcineurin inhibitor exposure with antibody induction and recurrent hepatocellular carcinoma after liver transplantation

Cited by 5 publications

References 27 publications

Impact of Hypothermic Oxygenated Machine Perfusion on Hepatocellular Carcinoma Recurrence after Liver Transplantation

Impact of Hypothermic Oxygenated Machine Perfusion on Hepatocellular Carcinoma Recurrence after Liver Transplantation

Comments on: Induction Immunosuppression Does Not Worsen Tumor Recurrence After Liver Transplantation for Hepatocellular Carcinoma

Immunotherapy for hepatocellular carcinoma in liver transplant patients (Literature review)

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