Conflicts of Interest The authors of this manuscript have potential conflicts of interest to disclose: Dr. Patrick Northup – multicenter institutional clinical trials funded through Bayer and Bristol Meyer-Squibb. All others have no conflicts of interest to disclose.
Sorafenib therapy for hepatocellular carcinoma prior to liver transplant is associated with increased complications after transplant
Article first published online: 21 JUL 2011
© 2011 The Authors. Transplant International © 2011 European Society for Organ Transplantation
Volume 24, Issue 10, pages 991–998, October 2011
How to Cite
Truesdale, A. E., Caldwell, S. H., Shah, N. L., Argo, C. K., Al-Osaimi, A. M. S., Schmitt, T. M. and Northup, P. G. (2011), Sorafenib therapy for hepatocellular carcinoma prior to liver transplant is associated with increased complications after transplant. Transplant International, 24: 991–998. doi: 10.1111/j.1432-2277.2011.01299.x
- Issue published online: 6 SEP 2011
- Article first published online: 21 JUL 2011
- Received: 24 March 2011 Revision requested: 25 April 2011 Accepted: 19 June 2011 Published online: 21 July 2011
- cancer chemotherapy protocols;
- therapeutic chemoembolization;
- vascular endothelial growth factor
This study compared post-transplant outcomes of patients with hepatocellular carcinoma (HCC) who took sorafenib prior to orthotopic liver transplantation (OLT) with those patients who were not treated with sorafenib. Thirty-three patients with HCC who were listed for liver transplantation were studied: 10 patients were treated with sorafenib prior to transplantation in an attempt to prevent progression of HCC while awaiting transplant. The remaining 23 patients were considered controls. The mean duration of sorafenib use was 19.2 (SD 25.2) weeks. Overall death rates were similar between the sorafenib group and control group (20% vs. 8.7%, respectively, P = 0.56). However, the patients in the sorafenib group had a higher incidence of acute cellular rejection following transplantation (67% vs. 22%, OR = 7.2, 95% CI 1.3–39.6, P = 0.04). The sorafenib group also had a higher rate of early biliary complications (67% vs. 17%, OR = 9.5, 1.6–55.0, P = 0.01). The use of sorafenib was found to be an independent predictor of post-transplant biliary complications (OR 12.6, 1.4–116.2, P = 0.03). Sorafenib administration prior to OLT appears to be associated with an increase in biliary complications and possibly in acute rejection following liver transplantation. Caution should be taken in this setting until larger studies are completed.