ArticleAmerican journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons2022
Cumulative exposure to tacrolimus and incidence of cancer after liver transplantation.
Article in American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 57 papers, 2 of them syntheses that pooled it.
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Who cites it
57 citing papers in PubMed, 2 syntheses or guidelines pooled it, 94 citations in OpenAlex.
- British Society of Gastroenterology guidelines for diagnosis and management of autoimmune hepatitis.Gut · 2025Guideline
- Lung cancer incidences after liver transplantation: A systematic review and meta-analysis.Cancer medicine · 2023Pooled it
- Comparing the efficacy and safety of thromboprophylaxis with enoxaparin versus normal saline after liver transplantation: randomized clinical trial.The British journal of surgery · 2025Trial
- Population Pharmacokinetic/Pharmacodynamic Model of the Impact of Cumulative Tacrolimus Exposure on Kidney Function After Liver Transplant.Therapeutic drug monitoring · 2026Article
- Cumulative exposure to tacrolimus is associated with increased risk of malignancy for solid organ transplant recipients.International journal of cancer · 2026Article
- Tacrolimus as Single-Agent Immunotherapy for Adult-Onset Myasthenia Gravis: Remission, Relapse, and Safety.CNS neuroscience & therapeutics · 2026Article
- Induction of Clinical Operational Tolerance Through Immunosuppression Minimization: Less Is More?Liver international : official journal of the International Association for the Study of the Liver · 2026Review
- Article
- Tacrolimus-Associated Adverse Effects After Liver Transplantation: A Narrative Review.Journal of clinical medicine · 2026Review
- Post-transplant hepatocellular carcinoma: balancing immunosuppression and immune checkpoint inhibitors.Clinical and molecular hepatology · 2026Review
- Systemic Treatment for Hepatocellular Carcinoma Recurrence After Liver Transplantation.Current oncology (Toronto, Ont.) · 2026Review
- De Novo Malignancies after Liver Transplantation: A Multicenter Cohort Study of Incidence, Timing, and Outcomes.The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology · 2026Article
- Steatotic liver disease and liver transplantation: Candidate selection and post-transplant management.JHEP reports : innovation in hepatology · 2026Review
- Does Atherosclerosis Progress Faster After Liver Transplant? A Comparative Study and Analysis of Progression Risk Factors.Journal of transplantation · 2026Article
- Risks of uterus transplantation: a scoping review.Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia · 2026Article
- Establishing a novel mouse model of tacrolimus-induced post-transplant hepatocellular carcinoma pulmonary recurrence for transplant oncology.Frontiers in cell and developmental biology · 2026Article
- Review
- Cancer Risk in Patients With Systemic Sclerosis: A Nationwide Cohort Study in South Korea 2004 to 2021.Arthritis care & research · 2025Article
- [Novel research horizon for liver transplantation management model in hepatocellular carcinoma based on the tumor-donor liver-recipient].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2025Article
- The Effect of Anti-Viral Treatment of HCV Infection on Outcomes of Renal Transplant Patients with Chronic HCV Infection: A Real-World Cohort Study.Biomedicines · 2025Article
Corrections and comments
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Authors and funding
20 authors at 15 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Cancer is the leading cause of death after liver transplantation (LT). This multicenter case-control nested study aimed to evaluate the effect of maintenance immunosuppression on post-LT malignancy. The eligible cohort included 2495 LT patients who received tacrolimus-based immunosuppression. After 13 922 person/years follow-up, 425 patients (19.7%) developed malignancy (cases) and were matched with 425 controls by propensity score based on age, gender, smoking habit, etiology of liver disease, and hepatocellular carcinoma (HCC) before LT. The independent predictors of post-LT malignancy were older age (HR = 1.06 [95% CI 1.05-1.07]; p < .001), male sex (HR = 1.50 [95% CI 1.14-1.99]), smoking habit (HR = 1.96 [95% CI 1.42-2.66]), and alcoholic liver disease (HR = 1.53 [95% CI 1.19-1.97]). In selected cases and controls (n = 850), the immunosuppression protocol was similar (p = .51). An increased cumulative exposure to tacrolimus (CET), calculated by the area under curve of trough concentrations, was the only immunosuppression-related predictor of post-LT malignancy after controlling for clinical features and baseline HCC (CET at 3 months p = .001 and CET at 12 months p = .004). This effect was consistent for de novo malignancy (after excluding HCC recurrence) and for internal neoplasms (after excluding non-melanoma skin cancer). Therefore, tacrolimus minimization, as monitored by CET, is the key to modulate immunosuppression in order to prevent cancer after LT.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.