The influence of sirolimus-based immnosuppression on hepatocellular carcinoma recurrence post-liver transplantation

Objective To investigate the influence of sirolimus-based immunosuppressive protocols on the survival and tumor recurrence in liver transplantation (LT) recipients with hepatocellular carcinoma (HCC).Method We retrospectively analyzed 142 patients who underwent LT for HCC in our hospital during Jan.2006 to Jan.2011,who were divided into SRL-treat group (62 cases) and control group (80 cases) The disease-free and tumor bearing survival time were compared using the Kaplan-Meier method.Results No significant difference was observed between these two groups with the disease-free survival time (DFS).There were no significant differences of the DFS patients who meet milan criteria,between milan ～UCSF and beyond UCSF criteria between these two groups.In the control group,the median tumor bearing survival time was 12 months (3-47 months) in 21 patiens who add the SRL in the immunosuppressive protocols after tumor recurrence,which was 8 months (6-22months) in 14 patients who continue the used immunosuppressive protocols after tumor recurrence.There was significant difference in the tumor bearing survival time between these patients (P =0.039).Compared with the control group,the SRL group had significantly lower diabetes while had a higher rate of hyperlipemia and oral ulcer (P＜0.05).Conclusion The sirolimusbasd immunosuppression may not benefit for all HCC patients after LT,but it may inhibit the growth of tumor and prolong the survival time of patients with tumor recurrence after LT; it can reduce the diabetes rate. Key words: Hepatocellular carcinoma;  Liver transplantation;  Sirolimus;  Survival rate;  Neoplasm recurrence