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A mixed blessing for liver transplantation patients -- Rapamycin |
Guang-Han Fan a ,b ,c ,d ,# , Chen-Zhi Zhang e ,# , Feng-Qiang Gao a ,b ,c ,d ,# , Xu-Yong Wei a ,c ,d ,f , Sun-Bin Ling a ,c ,d , Kai Wang a ,c ,d ,f , Jian-Guo Wang a ,c ,d , Shu-Sen Zheng d ,g ,h ,i , Mehrdad Nikfarjam j , Xiao Xu b ,c ,d ,f ,∗ |
a Department of Hepatobiliary and Pancreatic Surgery, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China
b Zhejiang University School of Medicine, Hangzhou 310058, China
c Key Laboratory of Integrated Oncology and Intelligent Medicine of Zhejiang Province, Hangzhou 310006, China
d Institute of Organ Transplantation, Zhejiang University, Hangzhou 310003, China
e State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer, Guangzhou 510060, China
f Westlake Laboratory of Life Sciences and Biomedicine, Hangzhou 310024, China
g Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
h Department of Hepatobiliary and Pancreatic Surgery, Shulan (Hangzhou) Hospital, Hangzhou 310000, China
i NHC Key Laboratory of Combined Multi-Organ Transplantation, Hangzhou 310003, China
j Department of Surgery, University of Melbourne, Austin Health, Heidelberg, VIC 3084, Australia
∗Corresponding author at: Zhejiang University School of Medicine, Hangzhou 310058, China.
E-mail address: zjxu@zju.edu.cn (X. Xu).
# Contributed equally. |
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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.
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