000117700 001__ 117700
000117700 005__ 20240319081010.0
000117700 0247_ $$2doi$$a10.1111/ajt.17021
000117700 0248_ $$2sideral$$a129247
000117700 037__ $$aART-2022-129247
000117700 041__ $$aeng
000117700 100__ $$aRodriguez-Peralvarez, Manuel
000117700 245__ $$aCumulative exposure to tacrolimus and incidence of cancer after liver transplantation
000117700 260__ $$c2022
000117700 5060_ $$aAccess copy available to the general public$$fUnrestricted
000117700 5203_ $$aCancer is the leading cause of death after liver transplantation (LT). This multicenter case-control nested study aimed to evaluate the effect of maintenance immunosuppression on post-LT malignancy. The eligible cohort included 2495 LT patients who received tacrolimus-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.
000117700 540__ $$9info:eu-repo/semantics/openAccess$$aby-nc-nd$$uhttp://creativecommons.org/licenses/by-nc-nd/3.0/es/
000117700 590__ $$a8.7$$b2022
000117700 592__ $$a2.776$$b2022
000117700 591__ $$aTRANSPLANTATION$$b2 / 26 = 0.077$$c2022$$dQ1$$eT1
000117700 593__ $$aImmunology and Allergy$$c2022$$dQ1
000117700 591__ $$aSURGERY$$b8 / 213 = 0.038$$c2022$$dQ1$$eT1
000117700 593__ $$aTransplantation$$c2022$$dQ1
000117700 593__ $$aPharmacology (medical)$$c2022$$dQ1
000117700 594__ $$a15.9$$b2022
000117700 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion
000117700 700__ $$aColmenero, Jordi
000117700 700__ $$aGonzalez, Antonio
000117700 700__ $$aGastaca, Mikel
000117700 700__ $$aCurell, Anna
000117700 700__ $$aCaballero-Marcos, Aranzazu
000117700 700__ $$aSanchez-Martinez, Ana
000117700 700__ $$aDi Maira, Tommaso
000117700 700__ $$aIgnacio Herrero, Jose
000117700 700__ $$aAlmohalla, Carolina
000117700 700__ $$0(orcid)0000-0003-4672-8083$$aLorente Pérez, Sara$$uUniversidad de Zaragoza
000117700 700__ $$aCuadrado-Lavin, Antonio
000117700 700__ $$aPascual, Sonia
000117700 700__ $$aAngeles Lopez-Garrido, Maria
000117700 700__ $$aGonzalez-Grande, Rocio
000117700 700__ $$aGomez-Orellana, Antonio
000117700 700__ $$aAlejandre, Rafael
000117700 700__ $$aZamora-Olaya, Javier
000117700 700__ $$aBernal-Bellido, Carmen
000117700 7102_ $$11007$$2610$$aUniversidad de Zaragoza$$bDpto. Medicina, Psiqu. y Derm.$$cArea Medicina
000117700 773__ $$g22, 6 (2022), 1671-1682$$pAM J TRANSPLANT$$tAMERICAN JOURNAL OF TRANSPLANTATION$$x1600-6135
000117700 8564_ $$s1990099$$uhttps://zaguan.unizar.es/record/117700/files/texto_completo.pdf$$yVersión publicada
000117700 8564_ $$s2244111$$uhttps://zaguan.unizar.es/record/117700/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada
000117700 909CO $$ooai:zaguan.unizar.es:117700$$particulos$$pdriver
000117700 951__ $$a2024-03-18-15:04:03
000117700 980__ $$aARTICLE