1
|
Lao Q, Wu X, Zheng X, Hu J, Huang S, Li D, Du Y, Yang N, Zhu H. Effect of Tacrolimus Time in Therapeutic Range on Postoperative Recurrence in Patients Undergoing Liver Transplantation for Liver Cancer. Ther Drug Monit 2024; 46:42-48. [PMID: 37315150 PMCID: PMC10769175 DOI: 10.1097/ftd.0000000000001119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 05/02/2023] [Indexed: 06/16/2023]
Abstract
BACKGROUND AND OBJECTIVE Liver cancer is the second highest cause of cancer-related deaths worldwide. It is commonly treated with liver transplantation, where tacrolimus is typically used as an antirejection immunosuppressant. The purpose of this study was to evaluate the effect of tacrolimus time in therapeutic range (TTR) on liver cancer recurrence in liver transplant recipients and to compare the performance of TTRs calculated according to the target ranges recommended in published guidelines. METHODS A total of 84 patients who underwent liver transplantation for liver cancer were retrospectively included. Tacrolimus TTR was calculated using linear interpolation from the date of transplantation until recurrence or the last follow-up according to target ranges recommended in the Chinese guideline and international expert consensus. RESULT Twenty-four recipients developed liver cancer recurrence after liver transplantation. The CTTR (TTR calculated according to the Chinese guideline) for the recurrence group was significantly lower than that of the nonrecurrence group (26.39% vs. 50.27%, P < 0.001), whereas the ITTR (TTR calculated according to the international consensus) was not significantly different between the two groups (47.81% vs. 56.37%, P = 0.165). Multivariate survival analysis revealed that age, microvascular invasion, hepatocellular carcinoma, CTTR, and mean tacrolimus trough concentration were independent predictors of liver cancer recurrence after liver transplantation. CONCLUSIONS TTR predicts liver cancer recurrence in liver transplant recipients. The range of tacrolimus concentrations recommended in the Chinese guideline was more beneficial than that recommended in the international consensus for Chinese patients undergoing liver transplantation for liver cancer.
Collapse
Affiliation(s)
- Qianying Lao
- Department of Pharmacy, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Xuanyu Wu
- Department of Pharmacy, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Xinxin Zheng
- Department of Pharmacy, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Jinwei Hu
- Department of Pharmacy, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Siqi Huang
- Department of Pharmacy, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Danying Li
- Department of Pharmacy, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China; and
- Nanjing Medical Center for Clinical Pharmacy, Nanjing, China
| | - Yao Du
- Department of Pharmacy, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China; and
- Nanjing Medical Center for Clinical Pharmacy, Nanjing, China
| | - Na Yang
- Department of Pharmacy, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China; and
- Nanjing Medical Center for Clinical Pharmacy, Nanjing, China
| | - Huaijun Zhu
- Department of Pharmacy, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
- Department of Pharmacy, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China; and
- Nanjing Medical Center for Clinical Pharmacy, Nanjing, China
| |
Collapse
|
2
|
Mu L, Qi L, Long H, Huang J, Zhong Z, Shi X, Chen C, Ye Q. Photothermal Fibrous Chitosan/Polydopamine Sponge for Intraoperative Hemostasis and Prevention of Tumor Recurrence in Hepatocellular Carcinoma Resection. Adv Sci (Weinh) 2024; 11:e2304053. [PMID: 38029340 PMCID: PMC10797464 DOI: 10.1002/advs.202304053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 10/06/2023] [Indexed: 12/01/2023]
Abstract
Hepatectomy, a surgical procedure for liver cancer, is often plagued by high recurrence rates worldwide. The recurrence of liver cancer is primarily attributed to microlesions in the liver, changes in the immune microenvironment, and circulating tumor cells in the bloodstream. To address this issue, a novel intervention method that combines intraoperative hemostasis with mild photothermal therapy is proposed, which has the potential to ablate microlesions and improve the immune microenvironment simultaneously. Specifically, the integrated strategy is realized based on the fibrous chitosan/polydopamine sponge (CPDS), which is constructed from shearing-flow-induced oriented hybrid chitosan fibers and subsequent self-assembly of polydopamine. The CPDS demonstrates high elasticity, excellent water absorption, and photothermal conversion performance. The results confirm the efficient hemostatic properties of the fibrous CPDS in various bleeding models. Notably, in subcutaneous and orthotopic postoperative recurrence and metastasis models of hepatocellular carcinoma, the fibrous CPDS significantly inhibits local tumor recurrence and distant metastasis. Moreover, the combination with lenvatinib can substantially enhance the antitumor effect. This comprehensive treatment strategy offers new insights into hepatectomy of liver cancer, representing a promising approach for clinical management.
Collapse
Affiliation(s)
- Lanxin Mu
- National Quality Control Center for Donated Organ ProcurementHubei Key Laboratory of Medical Technology on TransplantationHubei Clinical Research Center for Natural Polymer Biological LiverHubei Engineering Center of Natural Polymer‐based Medical Materials, Zhongnan Hospital of Wuhan UniversityInstitute of Hepatobiliary Diseases of Wuhan University, Transplant Center of Wuhan UniversityWuhan430071China
| | - Luhe Qi
- School of Resource and Environmental ScienceHubei International Scientific and Technological Cooperation Base of Sustainable Resource and EnergyHubei Engineering Center of Natural Polymers‐Based Medical MaterialsHubei Biomass‐Resource Chemistry and Environmental Biotechnology Key LaboratoryWuhan UniversityWuhan430079China
| | - Haitao Long
- National Quality Control Center for Donated Organ ProcurementHubei Key Laboratory of Medical Technology on TransplantationHubei Clinical Research Center for Natural Polymer Biological LiverHubei Engineering Center of Natural Polymer‐based Medical Materials, Zhongnan Hospital of Wuhan UniversityInstitute of Hepatobiliary Diseases of Wuhan University, Transplant Center of Wuhan UniversityWuhan430071China
| | - Jing Huang
- School of Resource and Environmental ScienceHubei International Scientific and Technological Cooperation Base of Sustainable Resource and EnergyHubei Engineering Center of Natural Polymers‐Based Medical MaterialsHubei Biomass‐Resource Chemistry and Environmental Biotechnology Key LaboratoryWuhan UniversityWuhan430079China
| | - Zibiao Zhong
- National Quality Control Center for Donated Organ ProcurementHubei Key Laboratory of Medical Technology on TransplantationHubei Clinical Research Center for Natural Polymer Biological LiverHubei Engineering Center of Natural Polymer‐based Medical Materials, Zhongnan Hospital of Wuhan UniversityInstitute of Hepatobiliary Diseases of Wuhan University, Transplant Center of Wuhan UniversityWuhan430071China
| | - Xiaowen Shi
- School of Resource and Environmental ScienceHubei International Scientific and Technological Cooperation Base of Sustainable Resource and EnergyHubei Engineering Center of Natural Polymers‐Based Medical MaterialsHubei Biomass‐Resource Chemistry and Environmental Biotechnology Key LaboratoryWuhan UniversityWuhan430079China
| | - Chaoji Chen
- School of Resource and Environmental ScienceHubei International Scientific and Technological Cooperation Base of Sustainable Resource and EnergyHubei Engineering Center of Natural Polymers‐Based Medical MaterialsHubei Biomass‐Resource Chemistry and Environmental Biotechnology Key LaboratoryWuhan UniversityWuhan430079China
| | - Qifa Ye
- National Quality Control Center for Donated Organ ProcurementHubei Key Laboratory of Medical Technology on TransplantationHubei Clinical Research Center for Natural Polymer Biological LiverHubei Engineering Center of Natural Polymer‐based Medical Materials, Zhongnan Hospital of Wuhan UniversityInstitute of Hepatobiliary Diseases of Wuhan University, Transplant Center of Wuhan UniversityWuhan430071China
| |
Collapse
|