Foremost Concepts in Mechanisms of De Novo Post-Liver Transplantation Malignancy

Autor: Milena Peruhova, Monika Peshevska-Sekulovska, Gabriela Panayotova, Tsvetelina Velikova
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Zdroj: Gastroenterology Insights, Vol 12, Iss 3, Pp 283-292 (2021)
Druh dokumentu: article
ISSN: 2036-7422
2036-7414
DOI: 10.3390/gastroent12030025
Popis: In liver transplant patients, solid tumors and post-transplant lymphoproliferative disorders (PTLD) have emerged as significant long-term mortality causes. Additionally, it is assumed that de novo malignancy (DNM) after liver transplantation (LT) is the second-leading cause of death after cardiovascular complications. Well-established risk factors for PTLD and solid tumors are calcineurin inhibitors (CNIs), tacrolimus (TAC), and cyclosporine, the cornerstones of all immunosuppressive (IS) therapies used after LT. The loss of immunocompetence facilitated by the host immune system due to prolonged IS therapy leads to cancer development, including in LT patients. Hindering DNA repair mechanisms, promoting tumor cell invasiveness, and hampering apoptosis are critical events in tumorigenesis and tumor growth in LT patients resulting from IS administration. This paper aims to overview the refined mechanisms of IS-induced tumorigenesis after LT and the loss of immunocompetence facilitated by the host immune system due to prolonged IS therapy. In addition, we also discuss in detail the mechanisms of action in different types of IS regimen used after LT, and their putative effect on DNM.
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