Date: Tuesday, May 5, 2015
Session Time: 5:30pm-6:30pm
Presentation Time: 5:30pm-6:30pm
Location: Exhibit Hall E
Liver transplantation is only treatment for unresectable hepatocellular carcinoma (HCC). However, postoperative immunosuppression may act as an additional risk factor for tumour recurrence. Antineoplastic role of everolimus (EVR) in reducing the recurrence of HCC has been suggested in preclinical retrospective studies. But, prospective study data in this regard still limited. This prospective study aims to determine the possible impact of EVR used in early phase after living donor liver transplantation in HCC recipients.
Material and Methods:
In this single center prospective study, we followed up 30 sequential recipients that underwent LDLT for HCC at our institute from January 2012 to November 2012. EVR was started within 1 month (4th to 20th postoperative day) after LDLT in these patients as published in our previous study. 24 patients were enrolled in this prospective study after they met the eligibility criteria.
Sixteen patients (n=16) were within UCSF criteria (1 Non B Non C, 7 HBV & 8 HCV patients) while 8 patients (4 HBV & 4 HCV patients) were beyond UCSF criteria. 1-year disease free survival achieved was 100% for HCC recipients within UCSF criteria while recurrence was in 4.12% in recipients with HCC beyond UCSF at 12 months. At median follow up of 30 months, overall survival achieved was 87.50% (21/24) while disease free survival was achieved 83.33% of patients. For patients with HCC within UCSF criteria, the 30 months disease free survival was 93.75 %. Overall tumour diameter >10cm and major vessel invasion were direct risk factors for the recurrence of HCC.4 recipients in this cohort underwent salvage transplantation for recurrent HCC showed recurrence free survival till the longest available follow up. None of the studied patient developed acute rejection episodes. None of the patients developed hepatic arterial thrombosis, incisional hernia or wound infections as were the initial concerns.
Present prospective data concludes the positive impact of EVR on reduction in HCC recurrence in recipients that received EVR early phase after liver transplantation. The impact was much pronounced in recipients with HCC within UCSF criteria. In absence of these risk factors, such as larger tumour diameter and major vessel invasion, the recurrence of HCC is expected to be even lower.
To cite this abstract in AMA style:Jeng L, Thorat A, Yang H, Yeh C-C, Chen T-H, Hsu S-C. Impact of Everolimus On the Hepatocellular Carcinoma Recurrence After Living Donor Liver Transplantation When Used in Early Stage: A Single Center Prospective Study [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/impact-of-everolimus-on-the-hepatocellular-carcinoma-recurrence-after-living-donor-liver-transplantation-when-used-in-early-stage-a-single-center-prospective-study/. Accessed March 22, 2019.
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