Systematic Reviews
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Apr 27, 2024; 16(4): 650-660
Published online Apr 27, 2024. doi: 10.4254/wjh.v16.i4.650
Relative carcinogenicity of tacrolimus vs mycophenolate after solid organ transplantation and its implications for liver transplant care
Dorothy Liu, Mark M Youssef, Josephine A Grace, Marie Sinclair
Dorothy Liu, Josephine A Grace, Marie Sinclair, Department of Gastroenterology, Austin Health, Melbourne 3084, Victoria, Australia
Dorothy Liu, Marie Sinclair, Victorian Liver Transplant Unit, Austin Health, Melbourne 3084, Victoria, Australia
Dorothy Liu, Mark M Youssef, Josephine A Grace, Marie Sinclair, Department of Medicine, University of Melbourne, Melbourne 3084, Victoria, Australia
Author contributions: Liu D was involved in data interpretation, drafting of the original and revised manuscripts, and prepared some of the figures and tables; Youssef MM performed data acquisition and prepared some of the figures and tables; Sinclair M was responsible for the study design; Grace JA and Sinclair M were involved in data interpretation and critical revision of the manuscript; and all authors have read and approved the final manuscript.
Conflict-of-interest statement: The authors have no conflicts of interest to report.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
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: Dorothy Liu, B-BMed, MD, FRACP, Doctor, Department of Gastroenterology, Austin Health, 145 Studley Road, Heidelberg, Melbourne 3084, Victoria, Australia. dorothy.liu2@austin.org.au
Received: December 16, 2023
Peer-review started: December 16, 2023
First decision: January 17, 2024
Revised: January 30, 2024
Accepted: March 19, 2024
Article in press: March 19, 2024
Published online: April 27, 2024
Core Tip

Core Tip: Cumulative immunosuppression exposure is an important risk factor for the development of post-transplant malignancy. There is emerging evidence on the differential carcinogenic risk profile of individual immunosuppressive drugs, independent of the net immunosuppression effect. This review demonstrates that the evidence on the relative carcinogenicity of tacrolimus and mycophenolic acid, the two agents most commonly used as maintenance monotherapy in liver transplant patients, remains unclear. Further studies are required to determine the clinical relevance of previous experimental findings to enable physicians to tailor immunosuppression regimens to minimize individual malignancy risk in solid organ transplantation.