Statin, aspirin and metformin use and risk of hepatocellular carcinoma related outcomes following liver transplantation: A retrospective study  

作　　者：William Chung Kevin Wong Noel Ravindranayagam Lauren Tang Josephine Grace Darren Wong Danny Con Marie Sinclair Avik Majumdar Numan Kutaiba Samuel Hui Paul Gow Vijayaragavan Muralidharan Alexander Dobrovic Adam Testro 

机构地区：[1]Department of Gastroenterology,Austin Health,Heidelberg 3084,Victoria,Australia [2]Victorian Liver Transplant Unit,Austin Health,Heidelberg 3084,Victoria,Australia [3]Department of Radiology,Austin Health,Heidelberg 3084,Victoria,Australia [4]Department of Gastroenterology,Monash Health,Clayton 3168,Victoria,Australia [5]Department of Surgery,University of Melbourne,Austin Health,Heidelberg 3048,Victoria,Australia [6]Department of Surgery,Beacon Laboratory,Austin Precinct,The University of Melbourne,Austin Hospital,Heidelberg 3048,Victoria,Australia

出　　处：《World Journal of Transplantation》2024年第3期120-131,共12页世界移植杂志

基　　金：This study was approved by the Austin Health Human Ethics Research Committee(No.HREC/87459/Austin-2022).

摘　　要：BACKGROUND Liver transplantation(LT)is a potentially curative therapy for patients with hepatocellular carcinoma(HCC).HCC-recurrence following LT is associated with reduced survival.There is increasing interest in chemoprophylaxis to improve HCC-related outcomes post-LT.AIM To investigate whether there is any benefit for the use of drugs with proposed chemoprophylactic properties against HCC,and patient outcomes following LT.METHODS This was a retrospective study of adult patients who received Deceased Donor LT for HCC from 2005-2022,from a single Australian centre.Drug use was defined as statin,aspirin or metformin therapy for≥29 days,within 24 months post-LT.A cox proportional-hazards model with time-dependent covariates was used for survival analysis.Outcome measures were the composite-endpoint of HCC-recurrence and all-cause mortality,HCC-recurrence and HCC-related mortality.Sensitivity analysis was performed to account for immortality time bias and statin dosing.RESULTS Three hundred and five patients were included in this study,with 253(82.95%)males with a median age of 58.90 years.Aetiologies of liver disease were 150(49.18%)hepatitis C,73(23.93%)hepatitis B(HBV)and 33(10.82%)non-alcoholic fatty liver disease(NAFLD).56(18.36%)took statins,51(16.72%)aspirin and 50(16.39%)metformin.During a median follow-up time of 59.90 months,34(11.15%)developed HCC-recurrence,48(15.74%)died,17(5.57%)from HCC-related mortality.Statin,aspirin or metformin use was not associated with statistically significant differences in the composite endpoint of HCC-recurrence or all-cause mortality[hazard ratio(HR):1.16,95%CI:0.58-2.30;HR:1.21,95%CI:0.28-5.27;HR:0.61,95%CI:0.27-1.36],HCC-recurrence(HR:0.52,95%CI:0.20-1.35;HR:0.51,95%CI:0.14-1.93;HR 1.00,95%CI:0.37-2.72),or HCC-related mortality(HR:0.32,95%CI:0.033-3.09;HR:0.71,95%CI:0.14-3.73;HR:1.57,95%CI:0.61-4.04)respectively.Statin dosing was not associated with statist-ically significant differences in HCC-related outcomes.CONCLUSION Statin,metformin or aspirin use was not associ

关 键 词：Liver transplantation Hepatocellular carcinoma Transplant oncology STATINS HMG-Co-A reductase ASPIRIN METFORMIN Mammalian target of rapamycin 

分 类 号：R735.7[医药卫生—肿瘤] R657.3[医药卫生—临床医学]