Vol 19: Liver transplantation: immunosuppression and oncology.Reportar como inadecuado



 Vol 19: Liver transplantation: immunosuppression and oncology.


Vol 19: Liver transplantation: immunosuppression and oncology. - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

Descargar gratis o leer online en formato PDF el libro: Vol 19: Liver transplantation: immunosuppression and oncology.
This article is from Current Opinion in Organ Transplantation, volume 19.AbstractPurpose 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.



Autor: Rodriguez-Peralvarez, Manuel; De la Mata, Manuel; Burroughs, Andrew K.

Fuente: https://archive.org/







Documentos relacionados