Evaluation and Management of Liver Transplant Candidates With Prior Nonhepatic Cancer: Guidelines From the ILTS/SETH Consensus Conference

Abstract

Liver transplant in patients with prior nonhepatic cancer is a matter of concern, needing further research, development, and consensus guidelines. This International Liver Transplantation Society/Sociedad Española De Trasplante Hepático consensus conference document focuses on the role of liver transplantation in patients with a prior history of nonhepatic cancer. This document addresses (1) the evaluation of transplant candidates with prior cancers based on the assessment of prognosis, the natural history of individual cancers, and the emerging role for circulating DNA and minimal residual disease in these patients; (2) the impact of prior treatments, including immunotherapy for prior malignancies; and (3) the surveillance of posttransplant cancer recurrence. The consensus statement is based on previously published guidelines, as well as a review of the current, relevant, published literature.

Therapeutic Effects of Anti-PD1 Immunotherapy on Hepatocellular Carcinoma Under Administration of Tacrolimus

“…[25][26][27] An association between HCC recurrence and high tacrolimus trough levels and the length of exposure was also reported. 28 To assess the effect of tacrolimus on cancer, syngeneic HCC Hep-55.1C cells were inoculated subcutaneously into C57BL/6 mice that had begun to receive daily tacrolimus or saline control 7 d before tumor cell implantation (Figure 2A). The tumor volumes of the tacrolimus-treated mice were significantly larger than the control group (Figure 2B).…”

The ILTS-SETH Consensus Conference on Extrahepatic Cancer and Liver Transplantation: Paving the Way

“…The final consensus conference recommendations issued from the working groups are presented in this issue of Transplantation. [3][4][5][6] Given the breadth of the topics, these articles are not designed to be inclusive of detailed topic reviews but a summary of the most recent key data upon which guidance recommendations could be made. This introductory methodology applies to each of the aforementioned documents published herein.…”