期刊
WORLD JOURNAL OF GASTROENTEROLOGY
卷 21, 期 29, 页码 8753-8768出版社
BAISHIDENG PUBLISHING GROUP INC
DOI: 10.3748/wjg.v21.i29.8753
关键词
Liver transplantation; De novo neoplasms; Immunosuppression; mTOR inhibitors; Hepatocellular carcinoma
资金
- Novartis Farma, Italy
De novo neoplasms account for almost 30% of deaths 10 years after liver transplantation and are the most common cause of mortality in patients surviving at least 1 year after transplant. The risk of malignancy is two to four times higher in transplant recipients than in an age- and sex-matched population, and cancer is expected to surpass cardiovascular complications as the primary cause of death in transplanted patients within the next 2 decades. Since exposure to immunosuppression is associated with an increased frequency of developing neoplasm, long-term immunosuppression should be therefore minimized. Promising results in the prevention of hepatocellular carcinoma (HCC) recurrence have been reported with the use of mTOR inhibitors including everolimus and sirolimus and the ongoing open-label prospective randomized controlled SILVER. Study will provide more information on whether sirolimus-containing vs mTOR-inhibitor-free immunosuppression is more efficacious in reducing HCC recurrence.
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