Does mTORi base immunosuppression offer survival advantage  after liver transplantation for hepatocellular carcinoma?  Systematic review and meta-analysis of randomized controlled  trials

Garzali, Ibrahim Umar; aloun, ali; Abu-zeid, Ez el din

doi:10.14744/hf.2022.2022.0049

Does mTORi base immunosuppression offer survival advantage after liver transplantation for hepatocellular carcinoma? Systematic review and meta-analysis of randomized controlled trials

Ali ALOUN, (King Hussein Medical Centre, Department of Surgery, Amman, Jordan)

Ez el din Abu zeid, (Soroka Medical Centre, Department of Surgery, Beersheba, Israel)

Ibrahim Umar Garzali (Aminu Kano Teaching Hospital, Department of surgery, Nigeria)

Hepatology forum

1 0

Yıl: 2023 Cilt: 4 Sayı: 2 Sayfa Aralığı: 82 - 88 Metin Dili: İngilizce DOI: 10.14744/hf.2022.2022.0049 İndeks Tarihi: 03-06-2023

Does mTORi base immunosuppression offer survival advantage after liver transplantation for hepatocellular carcinoma? Systematic review and meta-analysis of randomized controlled trials

Öz:

Recurrence is still a problem after liver transplant for hepatocellular carcinoma (HCC). We performed an updated systematic review and me ta-analysis of randomized controlled trials comparing tumor recurrence of mammalian target of rapamycin inhibitors (mTORi) versus Calci neurin inhibitor-based immunosuppression after liver transplantation for HCC. A systematic search was conducted in the following databas es: MEDLINE, EMBASE, and Cochrane Central Register of Control Trials databases. The Medical Subject Headings used in the search in cluded: “sirolimus,” “everolimus,” “mTORi,” “HCC,” “mTORi,” “he patic transplantation” “randomized controlled trials,” and “liver trans plantation (LT)”. Seven randomized controlled trials were included for meta-analysis. There were a total of 1,365 patients, with 712 of these patients receiving calcineurin inhibitors (CNIs) while 653 had received mTORi. Our meta-analysis revealed that patients that received mTO Ri-based immunosuppression had superior recurrence-free survival (RFS) at 1 year and 3 years with a hazard ratio of 2.02 and 1.36, re spectively. Meta-analysis also showed that within the first 3 years after LT for HCC, patients receiving CNIs-based immunosuppression have a higher recurrence than those receiving mTORi-based immunosuppres sion. Our meta-analysis revealed that recipients of mTORi-based immu nosuppression had a superior OS at 1 year and 3 years. mTORi-based immunosuppression is associated with decreased early recurrence and improved RFS and overall survival.

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APA	aloun a, Abu-zeid E, Garzali I (2023). Does mTORi base immunosuppression offer survival advantage after liver transplantation for hepatocellular carcinoma? Systematic review and meta-analysis of randomized controlled trials. , 82 - 88. 10.14744/hf.2022.2022.0049
Chicago	aloun ali,Abu-zeid Ez el din,Garzali Ibrahim Umar Does mTORi base immunosuppression offer survival advantage after liver transplantation for hepatocellular carcinoma? Systematic review and meta-analysis of randomized controlled trials. (2023): 82 - 88. 10.14744/hf.2022.2022.0049
MLA	aloun ali,Abu-zeid Ez el din,Garzali Ibrahim Umar Does mTORi base immunosuppression offer survival advantage after liver transplantation for hepatocellular carcinoma? Systematic review and meta-analysis of randomized controlled trials. , 2023, ss.82 - 88. 10.14744/hf.2022.2022.0049
AMA	aloun a,Abu-zeid E,Garzali I Does mTORi base immunosuppression offer survival advantage after liver transplantation for hepatocellular carcinoma? Systematic review and meta-analysis of randomized controlled trials. . 2023; 82 - 88. 10.14744/hf.2022.2022.0049
Vancouver	aloun a,Abu-zeid E,Garzali I Does mTORi base immunosuppression offer survival advantage after liver transplantation for hepatocellular carcinoma? Systematic review and meta-analysis of randomized controlled trials. . 2023; 82 - 88. 10.14744/hf.2022.2022.0049
IEEE	aloun a,Abu-zeid E,Garzali I "Does mTORi base immunosuppression offer survival advantage after liver transplantation for hepatocellular carcinoma? Systematic review and meta-analysis of randomized controlled trials." , ss.82 - 88, 2023. 10.14744/hf.2022.2022.0049
ISNAD	aloun, ali vd. "Does mTORi base immunosuppression offer survival advantage after liver transplantation for hepatocellular carcinoma? Systematic review and meta-analysis of randomized controlled trials". (2023), 82-88. https://doi.org/10.14744/hf.2022.2022.0049

APA	aloun a, Abu-zeid E, Garzali I (2023). Does mTORi base immunosuppression offer survival advantage after liver transplantation for hepatocellular carcinoma? Systematic review and meta-analysis of randomized controlled trials. Hepatology forum, 4(2), 82 - 88. 10.14744/hf.2022.2022.0049
Chicago	aloun ali,Abu-zeid Ez el din,Garzali Ibrahim Umar Does mTORi base immunosuppression offer survival advantage after liver transplantation for hepatocellular carcinoma? Systematic review and meta-analysis of randomized controlled trials. Hepatology forum 4, no.2 (2023): 82 - 88. 10.14744/hf.2022.2022.0049
MLA	aloun ali,Abu-zeid Ez el din,Garzali Ibrahim Umar Does mTORi base immunosuppression offer survival advantage after liver transplantation for hepatocellular carcinoma? Systematic review and meta-analysis of randomized controlled trials. Hepatology forum, vol.4, no.2, 2023, ss.82 - 88. 10.14744/hf.2022.2022.0049
AMA	aloun a,Abu-zeid E,Garzali I Does mTORi base immunosuppression offer survival advantage after liver transplantation for hepatocellular carcinoma? Systematic review and meta-analysis of randomized controlled trials. Hepatology forum. 2023; 4(2): 82 - 88. 10.14744/hf.2022.2022.0049
Vancouver	aloun a,Abu-zeid E,Garzali I Does mTORi base immunosuppression offer survival advantage after liver transplantation for hepatocellular carcinoma? Systematic review and meta-analysis of randomized controlled trials. Hepatology forum. 2023; 4(2): 82 - 88. 10.14744/hf.2022.2022.0049
IEEE	aloun a,Abu-zeid E,Garzali I "Does mTORi base immunosuppression offer survival advantage after liver transplantation for hepatocellular carcinoma? Systematic review and meta-analysis of randomized controlled trials." Hepatology forum, 4, ss.82 - 88, 2023. 10.14744/hf.2022.2022.0049
ISNAD	aloun, ali vd. "Does mTORi base immunosuppression offer survival advantage after liver transplantation for hepatocellular carcinoma? Systematic review and meta-analysis of randomized controlled trials". Hepatology forum 4/2 (2023), 82-88. https://doi.org/10.14744/hf.2022.2022.0049