ArticleClinical transplantation2023
Antineoplastic chemotherapy and immunosuppression in liver transplant recipients: Squaring the circle?
Article in Clinical transplantation, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed, 4 citations in OpenAlex.
- Pancreatic Cancer after Living-Donor Liver Transplantation: A Case Report of Long-Term Recurrence-Free Survival after Pancreaticoduodenectomy Followed by Adjuvant Chemotherapy.Surgical case reports · 2026Article
- MicroRNA signatures of cancer risk in kidney transplant patients: insights from the COMETA study.Journal of translational medicine · 2025Observational
- Case study: Successful full-course chemotherapy administration in a liver transplant recipient diagnosed with central nervous system World Health Organization Grade 2 IDH mutant/1p-19q co-deleted oligodendroglioma.Neuro-oncology practice · 2025Article
- Antineoplastic chemotherapy and immunosuppression in liver transplant recipients: Squaring the circle?Clinical transplantation · 2023Article
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Authors and funding
9 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMalignancies are a major cause of late death after liver transplantation (LT). In LT recipients presenting a malignancy, antineoplastic chemotherapy is central part of the therapeutic arsenal, but management of both immunosuppressive and antineoplastic chemotherapy can be very challenging. The aim of the present retrospective study was to describe a recent single center cohort of LT recipients treated with antineoplastic cytotoxic chemotherapy.
methodsAll LT recipients who received antineoplastic chemotherapy in our center between 2005 and 2021 were included.
resultsThe study population included 72 antineoplastic chemotherapy courses in 69 patients. There was a majority of men (81.9%); median age at LT was 54.9 (range 1-68) and was 63.0 (18-79) at the diagnosis of malignancy. Lung carcinomas (23.6%), head and neck carcinomas (20.8%), lymphomas (16.7%), and recurrent hepatocellular carcinoma (HCC) (8.3%) were the most frequent malignancies. Neoadjuvant (30.6%), adjuvant (12.5%) or palliative (54.2%) chemotherapy was performed. Immunosuppressive regimen was modified from a calcineurin inhibitor (CNI)-based to an everolimus-based regimen (63.5% of CNI discontinuation). Median survival after diagnosis of malignancy was 22.5 months and 5-year survival was 30.1%. Chemotherapy regimen was considered optimal in 81.9% of the cases. Multivariate analysis disclosed that non-PTLD N+ stage malignancy (HR = 5.52 95%CI [1.40;21.69], p = .014), non-PTLD M+ stage malignancy (HR = 10.55 95%CI [3.20;34.73], p = .0001), and suboptimal chemotherapy (HR = 2.73 95%CI [1.34;5.56], p = .005) were significantly associated with poorer prognosis. No rejection episode occurred during chemotherapy.
conclusionsThe present study is the first one focused on antineoplastic chemotherapy in LT recipients. Our results suggest that immunosuppressive drugs and antineoplastic chemotherapy can be managed satisfactorily in most cases but this needs confirmation from larger cohorts.
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