A mixed blessing for liver transplantation patients - Rapamycin

Guang-Han Fan; Chen-Zhi Zhang; Feng-Qiang Gao; Xu-Yong Wei; Sun-Bin Ling; Kai Wang; Jian-Guo Wang; Shu-Sen Zheng; Mehrdad Nikfarjam; Xiao Xu

doi:10.1016/j.hbpd.2022.10.004

A mixed blessing for liver transplantation patients - Rapamycin

Hepatobiliary Pancreat Dis Int. 2023 Feb;22(1):14-21. doi: 10.1016/j.hbpd.2022.10.004. Epub 2022 Oct 20.

Authors

Guang-Han Fan¹, Chen-Zhi Zhang², Feng-Qiang Gao¹, Xu-Yong Wei³, Sun-Bin Ling⁴, Kai Wang³, Jian-Guo Wang⁴, Shu-Sen Zheng⁵, Mehrdad Nikfarjam⁶, Xiao Xu⁷

Affiliations

¹ Department of Hepatobiliary and Pancreatic Surgery, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China; Zhejiang University School of Medicine, Hangzhou 310058, China; Key Laboratory of Integrated Oncology and Intelligent Medicine of Zhejiang Province, Hangzhou 310006, China; Institute of Organ Transplantation, Zhejiang University, Hangzhou 310003, China.
² State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer, Guangzhou 510060, China.
³ Department of Hepatobiliary and Pancreatic Surgery, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China; Key Laboratory of Integrated Oncology and Intelligent Medicine of Zhejiang Province, Hangzhou 310006, China; Institute of Organ Transplantation, Zhejiang University, Hangzhou 310003, China; Westlake Laboratory of Life Sciences and Biomedicine, Hangzhou 310024, China.
⁴ Department of Hepatobiliary and Pancreatic Surgery, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China; Key Laboratory of Integrated Oncology and Intelligent Medicine of Zhejiang Province, Hangzhou 310006, China; Institute of Organ Transplantation, Zhejiang University, Hangzhou 310003, China.
⁵ Institute of Organ Transplantation, Zhejiang University, Hangzhou 310003, China; Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China; Department of Hepatobiliary and Pancreatic Surgery, Shulan (Hangzhou) Hospital, Hangzhou 310000, China; NHC Key Laboratory of Combined Multi-Organ Transplantation, Hangzhou 310003, China.
⁶ Department of Surgery, University of Melbourne, Austin Health, Heidelberg, VIC 3084, Australia.
⁷ Zhejiang University School of Medicine, Hangzhou 310058, China; Key Laboratory of Integrated Oncology and Intelligent Medicine of Zhejiang Province, Hangzhou 310006, China; Institute of Organ Transplantation, Zhejiang University, Hangzhou 310003, China; Westlake Laboratory of Life Sciences and Biomedicine, Hangzhou 310024, China. Electronic address: zjxu@zju.edu.cn.

PMID: 36328894
DOI: 10.1016/j.hbpd.2022.10.004

Abstract

Background: Liver transplantation (LT) is an effective treatment option for end-stage liver disease. Mammalian target of rapamycin (mTOR) inhibitors, such as rapamycin, are widely used post LT.

Data sources: In this review, we focused on the anti-cancer activities and metabolic side effects of rapamycin after LT. The literature available on PubMed for the period of January 1999-September 2022 was reviewed. The key words were rapamycin, sirolimus, liver transplantation, hepatocellular carcinoma, diabetes, and lipid metabolism disorder.

Results: Rapamycin has shown excellent effects and is safer than other immunosuppressive regimens. It has exhibited excellent anti-cancer activity and has the potential in preventing hepatocellular carcinoma (HCC) recurrence post LT. Rapamycin is closely related to two long-term complications after LT, diabetes and lipid metabolism disorders.

Conclusions: Rapamycin prevents HCC recurrence post LT in some patients, but it also induces metabolic disorders. Reasonable use of rapamycin benefits the liver recipients.

Keywords: Hepatocellular carcinoma; Liver transplantation; Metabolic disease; Rapamycin; Tumor recurrence.

Publication types

Review

MeSH terms

Carcinoma, Hepatocellular* / drug therapy
Humans
Liver Neoplasms* / drug therapy
Liver Transplantation* / adverse effects
Neoplasm Recurrence, Local / drug therapy
Sirolimus / adverse effects

Substances

Sirolimus