ObjectiveTo elucidate the mechanism of evolimus (EVR) and its application, efficacy and common adverse reactions in hepatocellular carcinoma (HCC) patients after liver transplantation.MethodRelevant literatures in recent years were searched through websites such as Wanfang, CNKI and PubMed, and the results were read, analyzed and summarized.ResultsCurrently, there are a wide variety of immunosuppressive agents for HCC patients after liver transplantation, and immunosuppressive treatment options are also diverse and there is no unified standard. Today is more widely used clinically used for transplantation immune inhibitors of calcineurin inhibitors (CNIs), but because of its renal toxicity and side effects and recurrence of HCC risk increases, CNIs in HCC patients after liver transplantation using gradually is restricted, and mammalian target of rapamycin (mTOR) inhibitors are valued, gradually into clinical immunosuppression after liver transplantation for treatment provides a new way of thinking. As an mTOR inhibitor, EVR is gradually being applied to HCC patients after liver transplantation.ConclusionAs an mTOR inhibitor only approved for use in HCC patients after liver transplantation in recent years, relevant literature studies have shown that EVR plays an important role in improving the success rate of transplantation, protecting renal function and inhibiting HCC recurrence.
Renal dysfunction is one of the common perioperative complications of liver transplantation, involving the preoperative, intraoperative, and postoperative stages. Its occurrence is closely associated with multiple factors, including underlying liver disease, intraoperative hemodynamic instability, ischemia-reperfusion injury, and immunosuppressive therapy. Renal injury not only affects recipients’ short-term outcomes, but may also lead to long-term deterioration of renal function, increase the risk of chronic kidney disease, and exert a sustained negative impact on quality of life. Although postoperative immunosuppressive therapy can effectively prevent rejection, long-term use—particularly of calcineurin inhibitors—may cause substantial nephrotoxicity. In recent years, strategies that use combination immunosuppressive regimens to reduce/minimize calcineurin inhibitors exposure and thereby preserve renal function have attracted increasing attention. Mammalian target of rapamycin inhibitors, which are commonly used immunosuppressants after liver transplantation, play an important role in preventing rejection, reducing tumor recurrence, and preserving renal function. This consensus aims to standardize the use and management of mammalian target of rapamycin inhibitors in the prevention and treatment of renal injury after liver transplantation, provide scientific, standardized, and rational guidance for the clinical application of immunosuppressive regimens, reduce the incidence of renal dysfunction, and help improve the quality of life of liver transplant recipients.