Treating ischaemia‐reperfusion injury with prostaglandin E1 reduces the risk of early hepatocellular carcinoma recurrence following liver transplantation

Kornberg, Arno; Witt, Ulrike; Kornberg, Jennifer; Frieß, Helmut; Thrum, Katharina

doi:10.1111/apt.13380

Cited by 23 publications

(32 citation statements)

References 43 publications

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“…The results of the present study point toward the importance of strategies aimed to decrease IRI particularly for patients within the standard selection criteria. A single retrospective study revealed decreased magnitude of IRI, as illustrated by low transaminase levels and decreased risk of HCC recurrence in patients receiving prostaglandin E1 analog alprostadil in the early period after liver transplantation 33 . The protective effects of ischemic preconditioning with respect to the development of metastases were also reported in a recent experimental study 14 .…”

Section: Discussionmentioning

confidence: 99%

Ischemia-reperfusion injury and the risk of hepatocellular carcinoma recurrence after deceased donor liver transplantation

Grąt

Krawczyk

Wronka

et al. 2018

Sci Rep

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This study aimed to evaluate the effects of ischemia-reperfusion injury (IRI) on the risk of hepatocellular carcinoma (HCC) recurrence after liver transplantation. Data of 195 patients were retrospectively analysed. Post-reperfusion aspartate (AST), alanine transaminase, and lactate dehydrogenase (LDH) levels were the primary measures of IRI. Tumour recurrence was the primary endpoint. Post-reperfusion AST was a continuous risk factor for tumour recurrence in patients within Milan criteria (p = 0.035), with an optimal cut-off of 1896 U/L. Recurrence-free survival of patients within Milan criteria and post-reperfusion AST of <1896 and ≥1896 U/L was 96.6% and 71.9% at 5 and 3.7 years, respectively (p = 0.006). Additionally, post-reperfusion AST and LDH exceeding the upper quartile significantly increased the risk of HCC recurrence in patients within Milan criteria (p = 0.039, hazard ratio [HR] = 5.99 and p = 0.040, HR = 6.08, respectively) and to a lesser extent, in patients within Up-to-7 criteria (p = 0.028, HR = 3.58 and p = 0.039, HR = 3.33, respectively). No other significant IRI effects were found in patients beyond the Up-to-7 criteria and in analyses stratified for independent risk factors for recurrence: tumour number and differentiation, alpha-fetoprotein, and microvascular invasion. Thus, IRI exerts major negative effects on the risk of HCC recurrence after liver transplantation in patients within standard and extended criteria.

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Section: Discussionmentioning

confidence: 99%

Ischemia-reperfusion injury and the risk of hepatocellular carcinoma recurrence after deceased donor liver transplantation

Grąt

Krawczyk

Wronka

et al. 2018

Sci Rep

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“…In addition, rate of early HCC relapse within 1 year from LT was significantly higher without PGE1 treatment (34% vs. 5.1%; P < 0.001). When stratified according the MC, PGE1-therapy did not exert an independent prognostic impact in Milan In, whereas it was identified as a significant and independent promoter of RFS in patients with MC Out patients (HR = 5.09; 95%CI 1.64-15.76; P = 0.005) [114] .…”

Section: Improving Cancer-specific Outcome By Mitigating I/r Injurymentioning

confidence: 85%

“…In a retrospective clinical analysis, our transplant group was able to demonstrate that early post-LT treatment with prostaglandin E1 (PGE1) reduces hepatic I/R damage and provides beneficial immunomodulatory capabilities, finally improving cancer-specific outcome [114] . In a series of 106 HCC LT patients, RFS rates at 3-and 5-year post LT were significantly better in the PGE1-treatment group (87.9%; 85.7%) compared to the non-PGE1 subset (65.3%; 63.1%; P = 0.003).…”

Section: Improving Cancer-specific Outcome By Mitigating I/r Injurymentioning

confidence: 99%

Liver transplantation for hepatocellular carcinoma - non-cancer factors and implications for improving outcome beyond standard tumor criteria

Kornberg¹,

Schernhammer²

2018

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How to cite this article: Kornberg A, Schernhammer M. Liver transplantation for hepatocellular carcinoma -non-cancer factors and implications for improving outcome beyond standard tumor criteria. Hepatoma Res 2018;4:60. http://dx. AbstractLiver transplantation (LT) is recognized as best treatment option in patients with early hepatocellular cancer (HCC) in underlying liver cirrhosis. Apart from tumor size and number implemented in the Milan criteria, which are current worldwide standards for patient selection, several biological tumor factors have been identified to affect cancer-specific outcome. In particular, grading and vascular tumor invasions were shown to correlate with aggressive biological tumor behavior and poor survival following LT. Identifying tumors with favorable biology is one important approach for expanding the pool of eligible liver recipients beyond the Milan burden limits. Improving the immunological state and condition for appropriate defense against circulating cancer cell attack may be another important prognostic aspect. Therefore, there is increasing interest in non-cancer factors related to the peritransplant period that may influence the oncological outcome by providing negative immunomodulatory actions. Considering and modulation of these non-HCC factors of prognosis might contribute in safely expanding the HCC LT selection criteria.

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“…2 Letter: cytomegalovirus colitis in a patient treated with ipilimumab for metastatic melanoma and we would like to report the case of a patient developing bloody diarrhoea after treatment with ipilimumab for metastatic melanoma.…”

Section: Acknowledgementmentioning

confidence: 99%

“…2 It works by prolonging T-cell activation, resulting in augmented host T-cell immunity and sustained immune response against tumour cells due to loss of tolerance. This immune dysregulation is associated with several immune-related adverse events including dermatitis, endocrinopathies, uveitis, hepatitis and colitis.…”

Section: Acknowledgementmentioning

confidence: 99%

Treating ischaemia‐reperfusion injury with prostaglandin E1 reduces the risk of early hepatocellular carcinoma recurrence following liver transplantation

Cited by 23 publications

References 43 publications

Ischemia-reperfusion injury and the risk of hepatocellular carcinoma recurrence after deceased donor liver transplantation

Ischemia-reperfusion injury and the risk of hepatocellular carcinoma recurrence after deceased donor liver transplantation

Liver transplantation for hepatocellular carcinoma - non-cancer factors and implications for improving outcome beyond standard tumor criteria

Letter: prostaglandin E1 therapy with alprostadil and risk reduction of early hepatic cellular carcinoma after liver transplantation – authors' reply

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