Sirolimus treatment for cirrhosis or hepatocellular carcinoma patients accompanied by psoriasis after liver transplantation: A single center experience

Zhou,Lin; Du,Guo‑Sheng; Pan,Li‑Chao; Zheng,Yong‑Gen; Liu,Zhi‑Jia; Shi,Hai‑Da; Yang,Shao‑Zhen; Shi,Xian‑Jie; Xuan,Meng; Feng,Li‑Kui; Zhu,Zhi‑Dong

doi:10.3892/ol.2017.7217

Sirolimus treatment for cirrhosis or hepatocellular carcinoma patients accompanied by psoriasis after liver transplantation: A single center experience

Authors:
- Lin Zhou
- Guo‑Sheng Du
- Li‑Chao Pan
- Yong‑Gen Zheng
- Zhi‑Jia Liu
- Hai‑Da Shi
- Shao‑Zhen Yang
- Xian‑Jie Shi
- Meng Xuan
- Li‑Kui Feng
- Zhi‑Dong Zhu
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Affiliations: Department of Hepatobiliary Surgery, Chinese PLA General Hospital, Beijing 100853, P.R. China, Department of Hepatobiliary Surgery, Organ Transplant Institute, Chinese PLA 309th Hospital, Beijing 100091, P.R. China
Published online on: October 18, 2017 https://doi.org/10.3892/ol.2017.7217
Pages: 7817-7824
Copyright: © Zhou et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

There is currently no consensus on the most suitable therapeutic approach for psoriasis (PS) co‑existing with posthepatic cirrhosis (PCs) and hepatocellular carcinoma (HCC) following liver transplantation (LT). The present study provides an analysis of the therapeutic experience of such patients. Five LT recipients (two with PC and three with HCC) with accompanying PS were included. The induction program consisted of methylprednisolone plus basiliximab treatment. The initial postoperative treatment scheme consisted of tacrolimus (FK506) plus mycophenolate mofetil (MMF) and hormone; the latter was withdrawn 1 week after LT. The patients with PC had been using FK506 with or without a postoperative MMF program; the patients with HCC and recurrence of PS had been switched to a sirolimus (SRL)‑based replacement therapy. Furthermore, all patients received anti‑hepatitis B virus (HBV) therapy. The patients were followed up after 8.3±1.5 years. There was a positive correlation between HBV‑DNA copy numbers, and psoriatic area and severity index (PASI) scores (r=0.97; P=0.006). The PASI scores were decreased significantly at 6 months following surgery compared with pre‑transplantation (P<0.05). The patients who had received the FK506‑based treatment experienced PS recurrence two years post‑transplantation. The PASI scores increased significantly (P<0.05) and then declined gradually, maintaining a stable level (P<0.05) by 1 year after switching to the SRL‑based treatment. The patients who had received the SRL‑based treatment exhibited no recurrence of PS. The results of the present study suggest that SRL therapy provides a promising novel treatment method for patients with PS following LT that may be superior to tacrolimus treatment. When co‑existing HBV is present pre‑transplantation, regular injection of human hepatitis B immunoglobulin should be used to prevent the HBV from relapsing or aggravating the PS.

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