Neoplastic disease after liver transplantation: Focus on de novo neoplasms.
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.
Patrizia Burra, Kryssia I Rodriguez-Castro, Multivisceral Transplant Unit, Department of Surgery, Oncology and Gastroenterology, Padua University Hospital, 35128 Padua, PD, Italy.
Patrizia
P
Burra
Patrizia Burra, Kryssia I Rodriguez-Castro, Multivisceral Transplant Unit, Department of Surgery, Oncology and Gastroenterology, Padua University Hospital, 35128 Padua, PD, Italy.
Kryssia I
KI
Rodriguez-Castro
D046148:Donor Selection; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects; D016031:Liver Transplantation / Q000009:adverse effects* / Q000401:mortality; D009369:Neoplasms / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality / Q000517:prevention & control; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D014019:Tissue Donors; D016896:Treatment Outcome
D007166:Immunosuppressive Agents
De novo neoplasms; Hepatocellular carcinoma; Immunosuppression; Liver transplantation; mTOR inhibitors