title: [Liver transplantation: personalized immunosuppression in patients with hepatitis C virus infection and hepatocellular carcinoma].
abstract: Transplantation has become the treatment of choice in end-stage liver disease, with 5-year survival rates of around 68-74% in European and North-American registries (www.unos.org, www.eltr.org, www.ont.es). These results are largely due to the development of powerful immunosuppressive agents, mainly calcineurin inhibitors. However, these immunosuppressive drugs are not free of adverse effects, especially nephrotoxicity. Moreover, two of the most frequent indications for transplantation, cirrhosis due to hepatitis C virus and hepatocellular carcinoma, can recur in the transplanted graft. Whether specific immunosuppression could be less harmful in these conditions is the subject of debate. With the greater use of suboptimal donors and of expanded criteria for liver transplantation in patients with hepatocellular carcinoma, aggressive recurrences can be expected to increase. The present review attempts to elucidate whether there is an immunosuppression strategy that could minimize the risk of aggressive tumoral recurrence or recurrence of hepatitis C.
authors.affiliation: Unidad de Hepatología y Trasplante Hepático, Hospital La Fe, Valencia, España.
authors.forename: Angel
authors.initials: A
authors.lastname: Rubín
authors.forename: Marina
authors.initials: M
authors.lastname: Berenguer
mesh_terms: D065095:Calcineurin Inhibitors; D006528:Carcinoma, Hepatocellular / Q000150:complications* / Q000601:surgery*; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000601:surgery*; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods*; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008103:Liver Cirrhosis / Q000601:surgery / Q000821:virology; D008113:Liver Neoplasms / Q000150:complications* / Q000601:surgery*; D016031:Liver Transplantation; D057285:Precision Medicine; D012008:Recurrence
chemical_list: D065095:Calcineurin Inhibitors; D007166:Immunosuppressive Agents