title: Pre-transplant utilization of sorafenib is not associated with increased complications after liver transplantation.
abstract: Hepatocellular carcinoma (HCC) is increasing in incidence, resulting in approximately 35% of orthotopic liver transplantation (OLT) performed each year. Sorafenib (SOR) is a multi-kinase inhibitor that is approved for the treatment of unresectable HCC. Concerns have been raised regarding the safety of SOR in patients undergoing major surgery. We retrospectively reviewed 79 consecutive patients with HCC receiving OLT. Patient data were compared for those who received SOR pre-OLT with those who did not. SOR was continued until time of transplant. During this time period, 15 patients received SOR pre-OLT and 64 did not. The two groups were similar with regards to demographic and clinical data. SOR patients were more likely to have larger tumors, more tumor nodules, and be outside of Milan criteria. The rate of recurrence of HCC was not different between the groups (13% in SOR group, 11% in no-SOR group). Surgical complications were not increased in patients receiving SOR prior to OLT. Survival rate was also similar between the two groups (median follow-up 19.7 months). In this small cohort of patients, use of SOR prior to liver transplantation does not confer an increased risk of surgical complications, even when continued until the day of surgery.
authors.affiliation: Center for Organ and Cell Transplantation, Scripps Clinic, San Diego, CA, USA. Frenette.Catherine@scrippshealth.org
authors.forename: Catherine T
authors.initials: CT
authors.lastname: Frenette
authors.forename: Maha
authors.initials: M
authors.lastname: Boktour
authors.forename: Sherilyn G
authors.initials: SG
authors.lastname: Burroughs
authors.forename: Ahmed
authors.initials: A
authors.lastname: Kaseb
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Aloia
authors.forename: Joseph
authors.initials: J
authors.lastname: Galati
authors.forename: Ahmed O
authors.initials: AO
authors.lastname: Gaber
authors.forename: Howard
authors.initials: H
authors.lastname: Monsour
authors.forename: Rafik M
authors.initials: RM
authors.lastname: Ghobrial
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects*; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy / Q000401:mortality / Q000601:surgery*; D005260:Female; D006085:Graft Survival; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000601:surgery*; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009536:Niacinamide / Q000009:adverse effects / Q000031:analogs & derivatives*; D010671:Phenylurea Compounds / Q000009:adverse effects*; D012189:Retrospective Studies; D000077157:Sorafenib
chemical_list: D000970:Antineoplastic Agents; D010671:Phenylurea Compounds; D009536:Niacinamide; D000077157:Sorafenib