mTOR inhibitor reduces nontumour-related death in liver transplantation for hepatocellular carcinoma
Abstract Sirolimus is a regularly applied immunosuppressant for patients undergoing liver transplantation (LT) for hepatocellular carcinoma (HCC). Sirolimus not only significantly inhibits HCC recurrence but also protects renal function. However, the improvement effect of sirolimus on nontumour-rela...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Springer
2024-03-01
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| Series: | Molecular Biomedicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s43556-024-00170-6 |
| _version_ | 1797266988158943232 |
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| author | Lincheng Zhang Peng Liu Li Zhuang Sunbin Ling Qifan Zhan Wei Zhou Renyi Su Lu Yin Qingyang Que Jiachen Hong Jiaqi Bao Chuxiao Shao Jinzhen Cai Shusen Zheng Xiao Xu |
| author_facet | Lincheng Zhang Peng Liu Li Zhuang Sunbin Ling Qifan Zhan Wei Zhou Renyi Su Lu Yin Qingyang Que Jiachen Hong Jiaqi Bao Chuxiao Shao Jinzhen Cai Shusen Zheng Xiao Xu |
| author_sort | Lincheng Zhang |
| collection | DOAJ |
| description | Abstract Sirolimus is a regularly applied immunosuppressant for patients undergoing liver transplantation (LT) for hepatocellular carcinoma (HCC). Sirolimus not only significantly inhibits HCC recurrence but also protects renal function. However, the improvement effect of sirolimus on nontumour-related death in patients is still unknown. The aim of our study was to investigate the therapeutic effect of sirolimus on nontumour-related deaths. In this study, we retrospectively enrolled 403 LT patients with HCC from January 1, 2015, to December 31, 2018. The median follow-up time was 47.1 months. The patients were divided into the sirolimus group (N = 184) and the sirolimus-free group (N = 219). There were no significant differences between the sirolimus group and the sirolimus-free group in survival (P = 0.054). In transplant patients who exceeded the Milan or Hangzhou criteria, the sirolimus group achieved higher survival than the sirolimus-free group (P = 0.005; P = 0.02). Moreover, multivariate analysis showed that sirolimus strongly reduced the hazard ratio (HR) for nontumour-related death in LT patients who exceeded the Milan (HR: 0.42; 95% CI: 0.18–1; P = 0.05) or Hangzhou criteria (HR: 0.26; 95% CI: 0.08–0.89; P = 0.032). HCC recurrence increased the risk of nontumour-related death. In conclusion, sirolimus-based immunosuppression can significantly reduce nontumour-related death in LT patients who exceed the criteria for transplantation. In addition, this finding will further promote the application of sirolimus after liver transplantation for hepatocellular carcinoma. |
| first_indexed | 2024-04-25T01:09:26Z |
| format | Article |
| id | doaj.art-78d29e0188e049ad9fe2fa7bc36e9de7 |
| institution | Directory Open Access Journal |
| issn | 2662-8651 |
| language | English |
| last_indexed | 2024-04-25T01:09:26Z |
| publishDate | 2024-03-01 |
| publisher | Springer |
| record_format | Article |
| series | Molecular Biomedicine |
| spelling | doaj.art-78d29e0188e049ad9fe2fa7bc36e9de72024-03-10T12:04:13ZengSpringerMolecular Biomedicine2662-86512024-03-015111210.1186/s43556-024-00170-6mTOR inhibitor reduces nontumour-related death in liver transplantation for hepatocellular carcinomaLincheng Zhang0Peng Liu1Li Zhuang2Sunbin Ling3Qifan Zhan4Wei Zhou5Renyi Su6Lu Yin7Qingyang Que8Jiachen Hong9Jiaqi Bao10Chuxiao Shao11Jinzhen Cai12Shusen Zheng13Xiao Xu14Affiliated Hangzhou First People’s Hospital, Zhejiang University School of MedicineOrgan Transplantation Center, The Affiliated Hospital of Qingdao UniversityShulan (Hangzhou) Hospital, Zhejiang Shuren University School of MedicineDepartment of Hepatobiliary and Pancreatic Surgery, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of MedicineAffiliated Hangzhou First People’s Hospital, Zhejiang University School of MedicineAffiliated Hangzhou First People’s Hospital, Zhejiang University School of MedicineAffiliated Hangzhou First People’s Hospital, Zhejiang University School of MedicineKey Laboratory of Integrated Oncology and Intelligent Medicine of Zhejiang ProvinceAffiliated Hangzhou First People’s Hospital, Zhejiang University School of MedicineHangzhou Normal UniversityZhejiang Chinese Medical UniversityDepartment of Hepatobiliary and Pancreatic Surgery, Lishui People’s HospitalOrgan Transplantation Center, The Affiliated Hospital of Qingdao UniversityShulan (Hangzhou) Hospital, Zhejiang Shuren University School of MedicineAffiliated Hangzhou First People’s Hospital, Zhejiang University School of MedicineAbstract Sirolimus is a regularly applied immunosuppressant for patients undergoing liver transplantation (LT) for hepatocellular carcinoma (HCC). Sirolimus not only significantly inhibits HCC recurrence but also protects renal function. However, the improvement effect of sirolimus on nontumour-related death in patients is still unknown. The aim of our study was to investigate the therapeutic effect of sirolimus on nontumour-related deaths. In this study, we retrospectively enrolled 403 LT patients with HCC from January 1, 2015, to December 31, 2018. The median follow-up time was 47.1 months. The patients were divided into the sirolimus group (N = 184) and the sirolimus-free group (N = 219). There were no significant differences between the sirolimus group and the sirolimus-free group in survival (P = 0.054). In transplant patients who exceeded the Milan or Hangzhou criteria, the sirolimus group achieved higher survival than the sirolimus-free group (P = 0.005; P = 0.02). Moreover, multivariate analysis showed that sirolimus strongly reduced the hazard ratio (HR) for nontumour-related death in LT patients who exceeded the Milan (HR: 0.42; 95% CI: 0.18–1; P = 0.05) or Hangzhou criteria (HR: 0.26; 95% CI: 0.08–0.89; P = 0.032). HCC recurrence increased the risk of nontumour-related death. In conclusion, sirolimus-based immunosuppression can significantly reduce nontumour-related death in LT patients who exceed the criteria for transplantation. In addition, this finding will further promote the application of sirolimus after liver transplantation for hepatocellular carcinoma.https://doi.org/10.1186/s43556-024-00170-6SirolimusLiver transplantationHepatocellular carcinomaNontumour-related death |
| spellingShingle | Lincheng Zhang Peng Liu Li Zhuang Sunbin Ling Qifan Zhan Wei Zhou Renyi Su Lu Yin Qingyang Que Jiachen Hong Jiaqi Bao Chuxiao Shao Jinzhen Cai Shusen Zheng Xiao Xu mTOR inhibitor reduces nontumour-related death in liver transplantation for hepatocellular carcinoma Molecular Biomedicine Sirolimus Liver transplantation Hepatocellular carcinoma Nontumour-related death |
| title | mTOR inhibitor reduces nontumour-related death in liver transplantation for hepatocellular carcinoma |
| title_full | mTOR inhibitor reduces nontumour-related death in liver transplantation for hepatocellular carcinoma |
| title_fullStr | mTOR inhibitor reduces nontumour-related death in liver transplantation for hepatocellular carcinoma |
| title_full_unstemmed | mTOR inhibitor reduces nontumour-related death in liver transplantation for hepatocellular carcinoma |
| title_short | mTOR inhibitor reduces nontumour-related death in liver transplantation for hepatocellular carcinoma |
| title_sort | mtor inhibitor reduces nontumour related death in liver transplantation for hepatocellular carcinoma |
| topic | Sirolimus Liver transplantation Hepatocellular carcinoma Nontumour-related death |
| url | https://doi.org/10.1186/s43556-024-00170-6 |
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