Sorafenib use in the transplant setting.

Liver transplantation is an established treatment for hepatocellular carcinoma and Sorafenib is a validated treatment in patients harboring advanced tumors. It is still not clear whether the association between the two treatments, with Sorafenib used in the neo-adjuvant, adjuvant or recurrence setting, is useful and cost-effective. This paper summarizes the present evidence in favor or against the use of Sorafenib in the scenario of liver transplantation for HCC, also debating the problem of toxicity, in particular when mTOR inhibitors, which play a central role in regulating cellular growth and proliferation, are used as immunosuppressants. Overall, the data would not support the use of Sorafenib in the pre- or post-LT setting as adjuvant therapy and additional studies are needed to reach sound conclusions on the topic.