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Related Concept Videos

Kidney Transplant II: Surgical Procedure01:26

Kidney Transplant II: Surgical Procedure

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Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living...
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Postoperative Nursing Management for Kidney Transplant PatientsPostoperative nursing management care includes monitoring the surgical site, encouraging early movement, and promoting lung health through breathing exercises. Nurses also administer prescribed medications like H2-blockers, such as famotidine, or proton pump inhibitors, like omeprazole, to help prevent gastrointestinal ulcers and bleeding. Fungal infections in the mouth and bladder can result from immunosuppressive and antibiotic...
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A kidney transplant is a surgical approach that involves replacing a non-functioning kidney with a healthy one from a donor. This procedure is often a treatment option for end-stage renal disease (ESRD) patients. The method requires careful recipient selection, including evaluating various medical and psychosocial factors. These criteria vary between transplant centers but generally include assessments of the patient's overall health, adherence to medical recommendations, and lifestyle...
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Tissue transplantation is a significant medical procedure involving the transfer of cells, tissues, or organs from a donor to a recipient, with the primary aim of restoring lost functions. This procedure is crucial in treating a broad spectrum of diseases, including kidney diseases, liver failure, heart disease, and certain types of cancers.
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Sorafenib use in the transplant setting.

Giulia Castelli1, Patrizia Burra, Anna Giacomin

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For liver transplantation (LT) in hepatocellular carcinoma (HCC), sorafenib (SFN) use before or after LT is not currently supported by data. More research is needed to determine its efficacy and cost-effectiveness.

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Area of Science:

  • Hepatobiliary Surgery
  • Medical Oncology
  • Transplant Medicine

Background:

  • Liver transplantation (LT) is a standard treatment for hepatocellular carcinoma (HCC).
  • Sorafenib (SFN) is approved for advanced HCC, but its role alongside LT is unclear.
  • Potential toxicities, especially with mTOR inhibitor immunosuppressants, warrant investigation.

Purpose of the Study:

  • To review current evidence on the use of SFN in conjunction with LT for HCC.
  • To evaluate the efficacy and cost-effectiveness of SFN in neoadjuvant, adjuvant, and recurrence settings.
  • To assess the safety profile of SFN, considering potential interactions with immunosuppressants.

Main Methods:

  • Systematic review of existing literature on SFN and LT for HCC.
  • Analysis of studies examining SFN use before, during, and after LT.
  • Evaluation of reported toxicity data and impact on immunosuppressive regimens.

Main Results:

  • Current data do not support the use of SFN in the pre- or post-LT setting for HCC.
  • Evidence regarding the efficacy and cost-effectiveness of SFN in combination with LT is insufficient.
  • Toxicity concerns, particularly with mTOR inhibitors, require careful consideration.

Conclusions:

  • The combination of SFN with LT for HCC is not currently recommended based on available evidence.
  • Further clinical trials are necessary to establish the safety and efficacy of SFN in the context of LT.
  • Optimal treatment strategies for advanced HCC in patients undergoing or eligible for LT require additional research.