Sirolimus‐based immunosuppression in liver transplantation for hepatocellular carcinoma: A meta‐analysis

Sirolimus (SRL) is a novel immunosuppressant with antitumor properties. We performed a meta‐analysis to determine whether SRL can improve patient survival and decrease the risks of tumor recurrence in patients with a pretransplant diagnosis of hepatocellular carcinoma (HCC). We searched databases fo...

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Bibliographic Details
Published in:Liver transplantation 2012-01, Vol.18 (1), p.62-69
Main Authors: Liang, Wenhua, Wang, Dongping, Ling, Xiaoting, Allen Kao, Andrew, Kong, Yuan, Shang, Yushu, Guo, Zhiyong, He, Xiaoshun
Format: Article
Language:English
Subjects:
Carcinoma, Hepatocellular - surgery
Female
Humans
Immunosuppressive Agents - adverse effects
Immunosuppressive Agents - therapeutic use
Liver Neoplasms - surgery
Liver Transplantation - immunology
Liver Transplantation - mortality
Male
Neoplasm Recurrence, Local - prevention & control
Risk Factors
Sirolimus - adverse effects
Sirolimus - therapeutic use
Survival Rate
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Summary:Sirolimus (SRL) is a novel immunosuppressant with antitumor properties. We performed a meta‐analysis to determine whether SRL can improve patient survival and decrease the risks of tumor recurrence in patients with a pretransplant diagnosis of hepatocellular carcinoma (HCC). We searched databases for controlled clinical trials assessing the survival and oncological benefits of SRL for liver transplant recipients with pretransplant HCC. Five studies with a total of 2950 participants were included in this study. In comparison with SRL‐free regimens, SRL‐based regimens improved overall survival at 1 [odds ratio (OR) = 4.53, 95% confidence interval (95% CI) = 2.31‐8.89], 3 (OR = 1.97, 95% CI = 1.29‐3.00), and 5 years (OR = 2.47, 95% CI = 1.72‐3.55). The pooled results showed that in comparison with SRL‐free regimens, SRL‐based regimens decreased tumor recurrence (OR = 0.42, 95% CI = 0.21‐0.83). No significant differences in the frequencies of episodes of major posttransplant complications were observed between the groups. In conclusion, SRL is generally safe and prolongs patient survival in liver transplant recipients with pretransplant HCC. Liver Transpl 18:62–69, 2012. © 2011 AASLD.
ISSN:1527-6465
1527-6473
DOI:10.1002/lt.22441