Calcineurin‐Inhibitor Discontinuation Could Reduce the Risk of De Novo Malignancies After Liver Transplantation for Alcohol‐Related Liver Disease
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Wiley
2024
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| author | Domitille Erard Anouk Steiner Olivier Boillot Elsa Thimonier Mélanie Vallin Florian Veyre Olivier Guillaud Sylvie Radenne Jérôme Dumortier |
| author_facet | Domitille Erard Anouk Steiner Olivier Boillot Elsa Thimonier Mélanie Vallin Florian Veyre Olivier Guillaud Sylvie Radenne Jérôme Dumortier Domitille Erard Anouk Steiner Olivier Boillot Elsa Thimonier Mélanie Vallin Florian Veyre Olivier Guillaud Sylvie Radenne Jérôme Dumortier |
| collection | Wiley Open Access |
| contents | Calcineurin‐Inhibitor Discontinuation Could Reduce the Risk of De Novo Malignancies After Liver Transplantation for Alcohol‐Related Liver Disease Domitille Erard Anouk Steiner Olivier Boillot Elsa Thimonier Mélanie Vallin Florian Veyre Olivier Guillaud Sylvie Radenne Jérôme Dumortier Clinical Transplantation ABSTRACTBackgroundDe novo malignancies are one of the leading causes of death after liver transplantation (LT), particularly in patients transplanted for alcohol‐related liver disease (ALD). This retrospective study aimed to assess risk factors for malignancies and to evaluate the impact of calcineurin inhibitor (CNI) discontinuation.MethodsFrom 1990 to 2015, all patients transplanted for ALD were included.ResultsA total of 493 patients were included, 77.9% were male and the median age at LT was 54 years. After LT, 278 de novo malignancies were diagnosed in 214 patients (43.4%). The cumulative incidence of de novo malignancies was 16.3% at 5 years, 34.4% at 10 years, and 49.8% at 15 years. In multivariate analysis, the independent risk factors were male gender (HR = 1.6), and active or weaned smoking (HR = 2.0). Discontinuation of CNI was a protective factor (HR = 0.6). Survival after diagnosis of de novo malignancy was 42.7% at 5 years and 27.5% at 10 years.ConclusionOur results confirm the major incidence of de novo malignancies after LT for ALD, as well as the important role of non‐modifiable risk factors such as smoking and gender. CNI discontinuation is a protective factor, and the only adaptable, and could be proposed in smoker male patients transplanted for ALD. 10.1111/ctr.70014 http://creativecommons.org/licenses/by-nc/4.0/ |
| doi_str_mv | 10.1111/ctr.70014 |
| format | Artículo Open Access |
| id | wiley_oa_10_1111_ctr_70014 |
| institution | Wiley Open Access |
| license_str_mv | http://creativecommons.org/licenses/by-nc/4.0/ |
| publishDate | 2024 |
| publisher | Wiley |
| record_format | wiley_oa |
| spellingShingle | Calcineurin‐Inhibitor Discontinuation Could Reduce the Risk of De Novo Malignancies After Liver Transplantation for Alcohol‐Related Liver Disease Domitille Erard Anouk Steiner Olivier Boillot Elsa Thimonier Mélanie Vallin Florian Veyre Olivier Guillaud Sylvie Radenne Jérôme Dumortier Clinical Transplantation Calcineurin‐Inhibitor Discontinuation Could Reduce the Risk of De Novo Malignancies After Liver Transplantation for Alcohol‐Related Liver Disease Domitille Erard Anouk Steiner Olivier Boillot Elsa Thimonier Mélanie Vallin Florian Veyre Olivier Guillaud Sylvie Radenne Jérôme Dumortier Clinical Transplantation ABSTRACTBackgroundDe novo malignancies are one of the leading causes of death after liver transplantation (LT), particularly in patients transplanted for alcohol‐related liver disease (ALD). This retrospective study aimed to assess risk factors for malignancies and to evaluate the impact of calcineurin inhibitor (CNI) discontinuation.MethodsFrom 1990 to 2015, all patients transplanted for ALD were included.ResultsA total of 493 patients were included, 77.9% were male and the median age at LT was 54 years. After LT, 278 de novo malignancies were diagnosed in 214 patients (43.4%). The cumulative incidence of de novo malignancies was 16.3% at 5 years, 34.4% at 10 years, and 49.8% at 15 years. In multivariate analysis, the independent risk factors were male gender (HR = 1.6), and active or weaned smoking (HR = 2.0). Discontinuation of CNI was a protective factor (HR = 0.6). Survival after diagnosis of de novo malignancy was 42.7% at 5 years and 27.5% at 10 years.ConclusionOur results confirm the major incidence of de novo malignancies after LT for ALD, as well as the important role of non‐modifiable risk factors such as smoking and gender. CNI discontinuation is a protective factor, and the only adaptable, and could be proposed in smoker male patients transplanted for ALD. 10.1111/ctr.70014 http://creativecommons.org/licenses/by-nc/4.0/ |
| title | Calcineurin‐Inhibitor Discontinuation Could Reduce the Risk of De Novo Malignancies After Liver Transplantation for Alcohol‐Related Liver Disease |
| topic | Clinical Transplantation |
| url | https://onlinelibrary.wiley.com/doi/10.1111/ctr.70014 |