New data show that perioperative
cytostatic therapy is beneficial in the case of
liver transplantation for
hepatic cancer. However, it has not been established clearly whether
chemotherapy interferes with graft rejection. We therefore studied the interactions between
tumor growth and graft rejection, especially with regard to
chemotherapy, using a combined
tumor/
transplantation model. As a
tumor model, we used the
Novikoff hepatoma, a malignant
hepatoma that was injected subcutaneously into the backs of rats. Heterotopic
heart grafting served as the
transplantation model. In a first step (a), we studied the effect of
cytostatic therapy on
tumor growth:
tumor cells were injected, and in four groups
epirubicin,
cyclosporine,
epirubicin +
cyclosporine, and placebo were applied, in corresponding groups,
transplantation was additionally performed.
Tumor growth was measured and the resected
tumors were examined by histology and immunohistology. In a second step (b), we studied the effect of
chemotherapy on graft rejection:
transplantation was performed and the above-mentioned drugs were applied; in corresponding groups, a solid
tumor was additionally induced and resected immediately before
transplantation. The results of these procedures were as follows: (a)
Epirubicin decreased
tumor growth and diminished the volume-increasing effect of
cyclosporine significantly. After
transplantation,
tumor growth was similar. (b)
Epirubicin prolonged graft survival significantly, and the combination with
cyclosporine had an augmenting effect. In the corresponding groups, graft survival was similar. In conclusions.
chemotherapy diminishes the
tumor-increasing effect of
cyclosporine and does not interfere negatively with graft survival. It might therefore be beneficial after
transplantation for
malignancy.