dc.creator | Rodríguez-Perálvarez, Manuel | es |
dc.creator | Colmenero, Jordi | es |
dc.creator | González, Antonio | es |
dc.creator | Gastaca, Mikel | es |
dc.creator | Curell, Anna | es |
dc.creator | Caballero Marcos, Aránzazu | es |
dc.creator | Gómez Bravo, Miguel Ángel | es |
dc.creator | Cepeda Franco, Carmen | es |
dc.date.accessioned | 2022-12-05T14:59:46Z | |
dc.date.available | 2022-12-05T14:59:46Z | |
dc.date.issued | 2022 | |
dc.identifier.citation | Rodríguez-Perálvarez, M., Colmenero, J., González, A., Gastaca, M., Curell, A., Caballero Marcos, A.,...,Cepeda Franco, C. (2022). Cumulative exposure to tacrolimus and incidence of cancer after liver transplantation. American Journal of Transplantation, 22 (6), 1671-1682. https://doi.org/10.1111/ajt.17021. | |
dc.identifier.issn | 1600-6135 | es |
dc.identifier.issn | 1600-6143 | es |
dc.identifier.uri | https://hdl.handle.net/11441/140174 | |
dc.description.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 immunosuppres sion on post-LT malignancy. The eligible cohort included 2495 LT patacrolimus-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. | es |
dc.format | application/pdf | es |
dc.format.extent | 12 p. | es |
dc.language.iso | eng | es |
dc.publisher | Wiley-Blackwell | es |
dc.relation.ispartof | American Journal of Transplantation, 22 (6), 1671-1682. | |
dc.rights | Attribution-NonCommercial-NoDerivatives 4.0 Internacional | * |
dc.rights.uri | http://creativecommons.org/licenses/by-nc-nd/4.0/ | * |
dc.subject | Hepatocellular carcinoma | es |
dc.subject | Immunosuppression | es |
dc.subject | Malignancy | es |
dc.subject | Neoplasm | es |
dc.subject | Tacrolimus | es |
dc.title | Cumulative exposure to tacrolimus and incidence of cancer after liver transplantation | es |
dc.type | info:eu-repo/semantics/article | es |
dcterms.identifier | https://ror.org/03yxnpp24 | |
dc.type.version | info:eu-repo/semantics/publishedVersion | es |
dc.rights.accessRights | info:eu-repo/semantics/openAccess | es |
dc.contributor.affiliation | Universidad de Sevilla. Departamento de Cirugía | es |
dc.relation.publisherversion | https://onlinelibrary.wiley.com/doi/10.1111/ajt.17021 | es |
dc.identifier.doi | 10.1111/ajt.17021 | es |
dc.contributor.group | Universidad de Sevilla. CTS664: Cirugía avanzada y trasplantes. Terapia celular y bioingeniería aplicada a la cirugía. | es |
dc.journaltitle | American Journal of Transplantation | es |
dc.publication.volumen | 22 | es |
dc.publication.issue | 6 | es |
dc.publication.initialPage | 1671 | es |
dc.publication.endPage | 1682 | es |