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

✍ Scribed by Wenhua Liang; Dongping Wang; Xiaoting Ling; Andrew Allen Kao; Yuan Kong; Yushu Shang; Zhiyong Guo; Xiaoshun He

• Publisher: John Wiley and Sons
• Year: 2011
• Tongue: English
• Weight: 786 KB
• Volume: 18
• Category: Article
• ISSN: 1527-6465
• DOI: 10.1002/lt.22441

✦ Synopsis

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) ¼ 4.53, 95% confidence interval (95% CI) ¼ 2.31-8.89], 3 (OR ¼ 1.97, 95% CI ¼ 1.29-3.00), and 5 years (OR ¼ 2.47, 95% CI ¼ 1.72-3.55). The pooled results showed that in comparison with SRL-free regimens, SRL-based regimens decreased tumor recurrence (OR ¼ 0.42, 95% CI ¼ 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.