Korean J Transplant.  2020 Dec;34(Supple 1):S116. 10.4285/ATW2020.OP-1033.

Impact of everolimus on survival after liver transplantation for hepatocellular carcinoma

• Kang I
• Joo DJ

• KMID: 2509306
• DOI: http://doi.org/10.4285/ATW2020.OP-1033

Abstract

Background
The objective of this study was to investigate whether everolimus (EVR) use affects long-term survival after liver transplantation (LT) in patients with hepatocellular carcinoma (HCC).
Methods
Data from 303 consecutive patients with HCC who underwent LT were retrospectively reviewed. The patients were divided into two groups: (1) patients treated with EVR in combination with calcineurin inhibitors (CNI) (EVR group, n=114), and (2) patients treated with CNI-based therapy without EVR (non-EVR group, n=189). Disease-free survival (DFS) and overall survival (OS) were compared between two groups, and prognostic factors for DFS and OS were evaluated.
Results
The EVR group exhibited more aggressive tumor biology than the non-EVR group, including a higher number of tumors (P=0.003), a higher prevalence of microscopic vascular invasion (P=0.017), and cases exceeding Milan criteria (P=0.029). Compared with the non-EVR group, the EVR group had significantly better DFS (P=0.029) and OS (P<0.001). In multivariate analysis, use of EVR was identified as an independent prognostic factor for DFS (hazard ratio [HR], 0.248; P=0.001) and OS (HR, 0.145; P<0.001).
Conclusions
In combination with CNI, EVR has the potential to prolong long-term survival in patients undergoing LT for HCC. These findings warrant further investigation in a well-designed prospective study.