Everolimus Does Not Alter Non-Hepatic Malignancy Following Liver Transplant

Document Type

Conference Proceeding

Publication Date

8-1-2025

Publication Title

Am J Transplant

Abstract

Purpose: Malignancy after solid organ transplant especially skin cancers is common phenomenon and remains a major etiology of post-transplant mortality. Some case reports and small single center studies highlight various antioncogenic effects of mammalian target of rapamycin (mTOR) inhibitor class of immunosuppressants especially everolimus. This study aims to assess the effect of everolimus on the incidence of post-transplant skin malignancy and outcomes among liver transplant recipients. Methods: A retrospective chart review of post liver transplant patients at a large tertiary center in the midwest who received a liver transplant between 1 2015-12 2019 was conducted. Patients were split into 3 groups: not on everolimus post-transplant (group 1), started on everolimus within 1 year of transplant and discontinued before 3 years (group 2) and on everolimus for at least 3 consecutive years post-transplant (group 3). Demographic data including age, gender and etiology of cirrhosis was collected with primary outcomes assessing incidence of skin cancer. Secondary outcomes included other malignancy, transplant rejection, and death. Linear regression model used to compare these groups (group 1 vs. 3 and 2 vs. 3). Results: Among 381 liver transplant recipients, 59 patients were started on everolimus within 1 year of transplant and discontinued before 3 years (15.4%, group 2) and 65 patients were on everolimus for 3 consecutive years (17.1%, group 3). 25 patients in group 1 (9.7%), 6 in group 2 (6.8%) and 6 (9.2%) developed some skin malignancy with squamous cell carcinoma the most common among all three groups. 26 patients in group 1 (10.1%), 6 in group 2 (6.8%) and 5 (7.7%) developed some other type of malignancy with hematologic (23%) most common in group 1 and GI (67%) in group 2 and 3 (80%). There was no significant difference in incidence of skin malignancy (group 1 vs 3, p = 0.835; group 2 vs 3, p =0.513) or other malignancy across the groups. Similarly no significant difference in death (group 1 vs 3, p = 0.502; group 2 vs 3, p =0.611) or transplant rejection (group 1 vs 3, p = 0.30; group 2 vs 3, p =0.066). Conclusions: Our data demonstrates everolimus did not have a protective effect against skin malignancy, other malignancy, rejection or death among liver transplant patients. Whether these findings were related to a small sample size or time frame is unclear. Further investigations are warranted with a larger sample size and over a longer period to evaluate the long term benefit this immunosuppressant may have. CITATION INFORMATION: Rehman S., Garg N., Rahman T., Abusuliman M., Saleem A., Jafri S. Everolimus Does Not Alter Non-Hepatic Malignancy Following Liver Transplant AJT, Volume 25, Issue 8 Supplement 1 DISCLOSURES: M. Abusuliman: None.

Volume

25

Issue

8

First Page

S709

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