eprintid: 1469793
rev_number: 35
eprint_status: archive
userid: 608
dir: disk0/01/46/97/93
datestamp: 2015-07-08 14:29:22
lastmod: 2021-10-18 00:24:07
status_changed: 2015-07-08 14:29:22
type: article
metadata_visibility: show
item_issues_count: 0
creators_name: Rodríguez-Perálvarez, M
creators_name: De la Mata, M
creators_name: Burroughs, AK
title: Liver transplantation
ispublished: pub
divisions: UCL
divisions: B02
divisions: C10
note: This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivitives 3.0 License, where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially. https://creativecommons.org/licenses/by-nc-nd/3.0/
abstract: Purpose of review: Long-term survival of liver transplant recipients is threatened by increased rates of de-novo malignancy and recurrence of hepatocellular carcinoma (HCC), both events tightly related to immunosuppression.

Recent findings: There is accumulating evidence linking increased exposure to immunosuppressants and carcinogenesis, particularly concerning calcineurin inhibitors (CNIs), azathioprine and antilymphocyte agents. A recent study including 219 HCC transplanted patients showed that HCC recurrence rates were halved if a minimization of CNIs was applied within the first month after liver transplant. With mammalian target of rapamycin (mTOR) inhibitors as approved immunosuppressants for liver transplant patients, pooled data from several retrospective studies have suggested their possible benefit for reducing HCC recurrence.

Summary: Randomized controlled trials with sufficiently long follow-up are needed to evaluate the influence of different immunosuppression protocols in preventing malignancy after LT. Currently, early minimization of CNIs with or without mTOR inhibitors or mycophenolate seems a rational strategy for patients with risk factors for de-novo malignancy or recurrence of HCC after liver transplant. A deeper understanding of the immunological pathways of rejection and cancer would allow for designing more specific and safer drugs, and thus to prevent cancer after liver transplant.
date: 2014-06
official_url: http://dx.doi.org/10.1097/MOT.0000000000000069
oa_status: green
full_text_type: pub
language: eng
primo: open
primo_central: open_green
verified: verified_manual
elements_source: crossref
elements_id: 1041756
doi: 10.1097/MOT.0000000000000069
lyricists_name: Burroughs, Andrew
lyricists_id: AKBUR15
full_text_status: public
publication: Current Opinion in Organ Transplantation
volume: 19
number: 3
pagerange: 253 - 260
issn: 1087-2418
citation:        Rodríguez-Perálvarez, M;    De la Mata, M;    Burroughs, AK;      (2014)    Liver transplantation.                   Current Opinion in Organ Transplantation , 19  (3)   253 - 260.    10.1097/MOT.0000000000000069 <https://doi.org/10.1097/MOT.0000000000000069>.       Green open access   
 
document_url: https://discovery.ucl.ac.uk/id/eprint/1469793/1/Liver_transplantation___immunosuppression_and.8.pdf