000162150 001__ 162150
000162150 005__ 20251017144653.0
000162150 0247_ $$2doi$$a10.3389/ti.2025.14553
000162150 0248_ $$2sideral$$a144703
000162150 037__ $$aART-2025-144703
000162150 041__ $$aeng
000162150 100__ $$aAguilera, Victoria
000162150 245__ $$aCytomegalovirus reactivation is associated with lower rates of hepatocellular carcinoma recurrence after liver transplantation
000162150 260__ $$c2025
000162150 5060_ $$aAccess copy available to the general public$$fUnrestricted
000162150 5203_ $$aIn patients with hepatocellular carcinoma (HCC), undergoing liver transplantation (LT), cytomegalovirus reactivation (CMVr) may modulate the immune system to prevent tumor recurrence. In this multicenter retrospective study (2010–2015) involving 15 institutions, we assessed the effect of early CMVr in tumor recurrence rates among 771-LT HCC patients with tacrolimus-based immunosuppression (88% men, mean age 58 years). CMV prophylaxis was implemented for 19.7% of patients, while the rest were managed with preemptive therapy. The Milan criteria were met by 88% of patients. Microvascular invasion was present in 12.7% of explanted livers. The serum AFP level before transplantation was 5.1 (3–15) ng/mL. After a median follow-up of 7.4 years, 101 patients (13%) experienced HCC recurrence. CMVr occurred in 235 patients (30.5%) at a median of 41.5 days post-LT and 42 patients (5.6%) had CMV disease. Cumulative exposure to tacrolimus within the first 3 months after LT was similar among patients with and without CMVr. In a multivariate Cox regression analysis, factors associated with an increased rate of HCC recurrence included microvascular invasion [HR:2.82, CI95%:1.55–5.14; p 0.0001], donation after circulatory determination of death [HR:4.43,CI95%:1.52–12.9; p 0.006) and diameter of the main nodule at explant [HR:1.04, CI95%:1.02–1.06; p < 0.001]. Meanwhile CMVr [HR:0.46, CI95%:0.23–0.93, p 0.031] and MELD [HR:0.93, CI95%:0.87–0.99; p0.017] exhibited protective effects. In conclusion, early CMVr may protect against HCC recurrence. The underlying immune mechanisms warrant further investigation.
000162150 536__ $$9info:eu-repo/grantAgreement/ES/ISCIII/FI20-00033$$9info:eu-repo/grantAgreement/ES/ISCIII/INT24-00021$$9info:eu-repo/grantAgreement/ES/ISCIII/MV22-00053$$9info:eu-repo/grantAgreement/ES/ISCIII/PI13-01770$$9info:eu-repo/grantAgreement/ES/ISCIII/PI18-01759$$9info:eu-repo/grantAgreement/ES/ISCIII/PI23-00088
000162150 540__ $$9info:eu-repo/semantics/openAccess$$aby$$uhttps://creativecommons.org/licenses/by/4.0/deed.es
000162150 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion
000162150 700__ $$aRomero Moreno, Sarai
000162150 700__ $$aConde, Isabel
000162150 700__ $$aRubín, Angel
000162150 700__ $$aCarvalho-Gomes, Angela
000162150 700__ $$aRomero, Mario
000162150 700__ $$aZamora-Olaya, Javier
000162150 700__ $$aGómez-Bravo, Miguel Angel
000162150 700__ $$aFuentes-Valenzuela, Esteban
000162150 700__ $$aDopazo, Cristina
000162150 700__ $$aBilbao, Nikita
000162150 700__ $$aGonzález, Antonio
000162150 700__ $$aSánchez-Martínez, Ana
000162150 700__ $$aPascual, Sonia
000162150 700__ $$aRivera-Esteban, Jesús
000162150 700__ $$aHerrero, José Ignacio
000162150 700__ $$aLorente, Sara
000162150 700__ $$aCuadrado-Lavín, Antonio
000162150 700__ $$aNogueras, Flor
000162150 700__ $$aMartínez-Arenas, Laura
000162150 700__ $$aGonzález-Grande, Rocío
000162150 700__ $$aBerenguer, Marina
000162150 700__ $$aRodriguez-Perálvarez, Manuel
000162150 773__ $$g38 (2025), 14553 [11 pp.]$$pTranspl. int.$$tTRANSPLANT INTERNATIONAL$$x0934-0874
000162150 8564_ $$s1450260$$uhttps://zaguan.unizar.es/record/162150/files/texto_completo.pdf$$yVersión publicada
000162150 8564_ $$s2742954$$uhttps://zaguan.unizar.es/record/162150/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada
000162150 909CO $$ooai:zaguan.unizar.es:162150$$particulos$$pdriver
000162150 951__ $$a2025-10-17-14:37:19
000162150 980__ $$aARTICLE