Sorafenib therapy for hepatocellular carcinoma prior to liver transplant is associated with increased complications after transplant

Summary This study compared post‐transplant outcomes of patients with hepatocellular carcinoma (HCC) who took sorafenib prior to orthotopic liver transplantation (OLT) with those patients who were not treated with sorafenib. Thirty‐three patients with HCC who were listed for liver transplantation we...

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Bibliographic Details
Published in:Transplant international 2011-10, Vol.24 (10), p.991-998
Main Authors: Truesdale, Aimee E., Caldwell, Stephen H., Shah, Neeral L., Argo, Curtis K., Al‐Osaimi, Abdullah M. S., Schmitt, Timothy M., Northup, Patrick G.
Format: Article
Language:English
Subjects:
Antineoplastic Agents - adverse effects
Antineoplastic Agents - therapeutic use
Benzenesulfonates - adverse effects
Benzenesulfonates - therapeutic use
cancer chemotherapy protocols
Carcinoma, Hepatocellular - drug therapy
Disease Progression
Female
hepatoma
Humans
Liver cancer
Liver cirrhosis
Liver Neoplasms - drug therapy
Liver Transplantation - methods
Male
Middle Aged
Niacinamide - analogs & derivatives
Phenylurea Compounds
Pilot Projects
Pyridines - adverse effects
Pyridines - therapeutic use
therapeutic chemoembolization
Time Factors
Transplants & implants
Treatment Outcome
vascular endothelial growth factor
Waiting Lists
Citations: Items that cite this one
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Summary:Summary This study compared post‐transplant outcomes of patients with hepatocellular carcinoma (HCC) who took sorafenib prior to orthotopic liver transplantation (OLT) with those patients who were not treated with sorafenib. Thirty‐three patients with HCC who were listed for liver transplantation were studied: 10 patients were treated with sorafenib prior to transplantation in an attempt to prevent progression of HCC while awaiting transplant. The remaining 23 patients were considered controls. The mean duration of sorafenib use was 19.2 (SD 25.2) weeks. Overall death rates were similar between the sorafenib group and control group (20% vs. 8.7%, respectively, P = 0.56). However, the patients in the sorafenib group had a higher incidence of acute cellular rejection following transplantation (67% vs. 22%, OR = 7.2, 95% CI 1.3–39.6, P = 0.04). The sorafenib group also had a higher rate of early biliary complications (67% vs. 17%, OR = 9.5, 1.6–55.0, P = 0.01). The use of sorafenib was found to be an independent predictor of post‐transplant biliary complications (OR 12.6, 1.4–116.2, P = 0.03). Sorafenib administration prior to OLT appears to be associated with an increase in biliary complications and possibly in acute rejection following liver transplantation. Caution should be taken in this setting until larger studies are completed.
ISSN:0934-0874
1432-2277
DOI:10.1111/j.1432-2277.2011.01299.x