Ahmed F, Zakaria F, Enebong Nya G, Mouchli M. Sirolimus vs tacrolimus: Which one is the best therapeutic option for patients undergoing liver transplantation for hepatocellular carcinoma? World J Gastrointest Surg 2022; 14(8): 862-866 [PMID: 36157369 DOI: 10.4240/wjgs.v14.i8.862]
Corresponding Author of This Article
Faiza Ahmed, BSc, MD, MSc, Instructor, Research Scientist, Senior Researcher, Division of Clinical and Translational Research, Larkin Community Hospital-Larkin Healthcare Systems, 7031 SW 62nd Ave, South Miami, FL 33143, United States. dr.faiza.ahmed11@gmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Letter to the Editor
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Faiza Ahmed, Division of Clinical and Translational Research, Larkin Community Hospital-Larkin Healthcare Systems, South Miami, FL 33143, United States
Faiza Zakaria, Department of Internal Medicine, Dow Medical College, Karachi 75400, Pakistan
Godsgift Enebong Nya, Department of Gastroenterology, John Hopkins Hospital, Baltimore, MD 21218, United States
Mohamad Mouchli, Department of Gastroenterology, Cleveland Clinic, Cleveland, OH 44195, United States
Author contributions: All authors contributed to the conception, writing, and review of the article and approved the submitted version.
Conflict-of-interest statement: The authors declare no conflict of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Faiza Ahmed, BSc, MD, MSc, Instructor, Research Scientist, Senior Researcher, Division of Clinical and Translational Research, Larkin Community Hospital-Larkin Healthcare Systems, 7031 SW 62nd Ave, South Miami, FL 33143, United States. dr.faiza.ahmed11@gmail.com
Received: January 31, 2022 Peer-review started: January 31, 2022 First decision: June 19, 2022 Revised: July 2, 2022 Accepted: July 20, 2022 Article in press: July 20, 2022 Published online: August 27, 2022 Processing time: 204 Days and 13 Hours
Abstract
Liver transplantation (LT) withstands as the most preferred therapeutic option for patients afflicted with hepatocellular carcinoma (HCC) and cirrhosis. To improve prognosis post-transplant, as well as to prevent the occurrence of rejection, a life-long immunosuppression strategy is implemented. The following letter to the editor highlights and provides novel evidence from recently published literature on topics discussed within the review article titled “Trends of rapamycin in survival benefits of liver transplantation for hepatocellular carcinoma” in World J Gastrointest Surg 2021; 13: 953-966. In the recent manuscript, the authors compared immunosuppressive drugs such as the newer option first-generation mammalian target of rapamycin inhibitor, also known as sirolimus, with the most widely used first-generation calcineurin inhibitors, such as tacrolimus (TAC). TAC is commonly known as the most effective immunosuppressive drug after LT, but it has been reported to cause intolerable side effects such as nephrotoxicity, neurotoxicity, diabetes, hypertension, gastrointestinal disturbances, increased risk of infections, and malignancies. It is necessary for physicians to be aware of recent advances in tacrolimus and sirolimus therapies to compare and understand distinctly the effectiveness and tolerability of these drugs. This will assist clinicians in making the best treatment decisions and improve the clinical prognosis of LT recipients with HCC.
Core Tip: Post-transplant rejection holds significance in the long-term survival of patients with hepatocellular carcinoma (HCC) receiving a liver transplant (LT). The role of the mammalian target of rapamycin inhibitor (mTOR inhibitors) in preventing HCC recurrence after LT is still under debate. The major goal of this letter is to summarize the most relevant existing data on sirolimus, an mTOR inhibitor, and tacrolimus, a calcineurin inhibitor, therapy involvement in the progression of such patients.
