Association between the early high level of serum tacrolimus and recurrence of hepatocellular carcinoma in ABO-incompatible liver transplantation  

作　　者：Ji Won Han Jong Young Choi Eun Sun Jung Ji Hoon Kim Hee Sun Cho Jae-Sung Yoo Pil Soo Sung Jeong Won Jang Seung Kew Yoon Ho Joong Choi Young Kyoung You 

机构地区：[1]Department of Internal Medicine,The Catholic University of Korea,Seoul 06591,South Korea [2]The Catholic University Liver Research Center,College of Medicine,The Catholic University of Korea,Seoul 06591,South Korea [3]Department of Hospital Pathology,The Catholic University of Korea,Seoul 06591,South Korea [4]Department of Surgery,The Catholic University of Korea,Seoul 06591,South Korea

出　　处：《World Journal of Gastrointestinal Surgery》2023年第12期2727-2738,共12页世界胃肠外科杂志（英文版）（电子版）

基　　金：Supported by National Research Foundation of Korea,NO.2022R1I1A1A0106363612;Korea Health Industry Development Institute,No.HI23C1489.

摘　　要：BACKGROUND Clinical factors predicting graft survival(GS)after ABO-incompatible(ABOi)liver transplantation(LT),and differences between recipients with and without hepatocellular carcinoma(HCC)are unclear.AIM To analyze the impact of serial serum tacrolimus trough concentration in recipients with or without(HCC)in ABOi living-donor liver transplantation(LDLT).METHODS We analyzed a historical cohort of 89 recipients who underwent ABOi LDLT,including 47 patients with HCC.RESULTS The 1-,3-,5-,and 10-year GS rates were 85.9%,73.3%,71.4%,and 71.4%,respectively,and there were no significant differences between HCC and non-HCC recipients.In multivariate Coxregression analyses,tacrolimus trough concentrations below 5.4 ng/mL at 24 wk post-LT,in addition to the antibody-mediated rejection(AMR)were associated with poor-graft outcomes.In HCC patients,AMR[hazard ratio(HR)=63.20,P<0.01]and HCC recurrence(HR=20.72,P=0.01)were significantly associated with poor graft outcomes.HCCs outside Milan criteria,and tacrolimus concentrations at 4 wk post-LT>7.3 ng/mL were significant predictive factors for HCC recurrence.After propensity score matching,patients with high tacrolimus concentrations at 4 wk had significantly poor recurrence-free survival.CONCLUSION Elevated tacrolimus levels at 4 wk after ABOi LDLT have been found to correlate with HCC recurrence.Therefore,careful monitoring and control of tacrolimus levels are imperative in ABOi LT recipients with HCC.

关 键 词：ABO-INCOMPATIBLE Liver transplantation TACROLIMUS Hepatocellular carcinoma 

分 类 号：R735.7[医药卫生—肿瘤]