title: Sirolimus-based immunosuppression in liver transplantation for hepatocellular carcinoma: a meta-analysis.
abstract: Sirolimus (SRL) is a novel immunosuppressant with antitumor properties. We performed a meta-analysis to determine whether SRL can improve patient survival and decrease the risks of tumor recurrence in patients with a pretransplant diagnosis of hepatocellular carcinoma (HCC). We searched databases for controlled clinical trials assessing the survival and oncological benefits of SRL for liver transplant recipients with pretransplant HCC. Five studies with a total of 2950 participants were included in this study. In comparison with SRL-free regimens, SRL-based regimens improved overall survival at 1 [odds ratio (OR) = 4.53, 95% confidence interval (95% CI) = 2.31-8.89], 3 (OR = 1.97, 95% CI = 1.29-3.00), and 5 years (OR = 2.47, 95% CI = 1.72-3.55). The pooled results showed that in comparison with SRL-free regimens, SRL-based regimens decreased tumor recurrence (OR = 0.42, 95% CI = 0.21-0.83). No significant differences in the frequencies of episodes of major posttransplant complications were observed between the groups. In conclusion, SRL is generally safe and prolongs patient survival in liver transplant recipients with pretransplant HCC.
authors.affiliation: Organ Transplant Center, First Affiliated Hospital, Sun Yat-sen University, 58 Zhongshan Er Road, Guangzhou, China.
authors.forename: Wenhua
authors.initials: W
authors.lastname: Liang
authors.forename: Dongping
authors.initials: D
authors.lastname: Wang
authors.forename: Xiaoting
authors.initials: X
authors.lastname: Ling
authors.forename: Andrew Allen
authors.initials: AA
authors.lastname: Kao
authors.forename: Yuan
authors.initials: Y
authors.lastname: Kong
authors.forename: Yushu
authors.initials: Y
authors.lastname: Shang
authors.forename: Zhiyong
authors.initials: Z
authors.lastname: Guo
authors.forename: Xiaoshun
authors.initials: X
authors.lastname: He
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000601:surgery*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D008113:Liver Neoplasms / Q000601:surgery*; D016031:Liver Transplantation / Q000276:immunology* / Q000401:mortality; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D012307:Risk Factors; D020123:Sirolimus / Q000009:adverse effects / Q000627:therapeutic use*; D015996:Survival Rate
chemical_list: D007166:Immunosuppressive Agents; D020123:Sirolimus