An E2F7/TSC1-based model for predicting the efficacy of sirolimus after liver transplantation for hepatocellular carcinoma beyond the Milan criteria

As a radical treatment for hepatocellular carcinoma(HCC),liver transplantation(LT)has become an ideal treatment option for certain HCC patients.For patients beyond the Milan criteria,high HCC recurrence risk is a vital factor affecting the prognosis.Sirolimus,a firstgeneration mammalian target of rapamycin(mTOR)inhibitor,decreased recurrence rates and prolonged overall survival(OS)compared with calcineurin inhibitors(CNI)-based mTOR inhibitor-free immunosuppression.[1]However,some patients taking sirolimus after LT regularly do still have HCC recurrence in clinical practice.Thus,predicting the efficacy of sirolimus from the perspective of molecular pathology is expected to break through this bottleneck.