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Although liver transplantation (LT) lengthens the survival time of patients with hepatocellular carcinoma (HCC), LT patients exhibit a high recurrence rate; particularly those that had advanced HCC associated with the tumor biological characteristics and long‑term application of immunosuppressants. A consensus on optimal prophylaxis and treatment for recurrent HCC following LT does not currently exist. The present study retrospectively analyzed data from 36 non‑University of California at San Francisco criteria‑eligible patients with advanced HCC who underwent LT, and then treated them with sirolimus (SRL)‑based therapy with thymalfasin and huaier granules (SRL+, n=18), or with tacrolimus‑based therapy (controls; n=18). The SRL+ group had significantly longer recurrence times (P=0.008) and survival times (P<0.0001) (OS, 1‑year: 100%, 3‑year: 94.4%, 5‑year: 77.8%; DFS, 1‑year: 88.9%, 3‑year: 55.6%, 5‑year: 50.0%). Furthermore, compared with pre‑LT values and the control group, the SRL+ group had significantly lower serum α‑fetoprotein (AFP) levels (both P<0.0001) and percentage of Forkhead box P3 (FoxP3)+ Treg lymphocytes (P<0.001) during the first year. In the SRL+ group, FoxP3+/cluster of differentiation (CD)8+ Treg lymphocyte percentages decreased significantly following LT (P<0.001); however, CD8+/CD3+ T‑cells significantly increased (P<0.001). Levels of serum AFP and FoxP3+ Treg cells increased when tumors relapsed, and decreased to near‑normal when relapse foci were cured or stabilized. SRL+ therapy may decrease AFP and Treg levels, while increasing CD8+ T cells, indicating an associated mechanism among them. In conclusion, SRL+ therapy appears to be safe and effective in preventing HCC recurrence following LT with no significant adverse events, and warrants further investigation. [ABSTRACT FROM AUTHOR]

MicroRNA‑424 (miR‑424) has previously been described as a biomarker of poor prognosis in patients with hepatocellular carcinoma (HCC). In the present study, the clinical significance of miR‑424 expression in predicting the rate of tumor recurrence in patients with HCC following liver transplantation (LT) was evaluated. miR‑424 expression in HCC samples from 121 patients undergoing LT was examined, and the associations between clinical parameters and patient tumor recurrence were evaluated. The miR‑424 expression level in cancer tissues was low compared with that in adjacent noncancerous tissues. Multivariate analyses revealed that low miR‑424 expression was an independent prognostic factor for tumor recurrence in patients with HCC following liver transplantation. Patients who no longer met the Milan criteria and had decreased miR‑424 expression levels exhibited earlier tumor recurrence following LT. In addition, the upregulation of miR‑424 expression significantly reduced the migration, invasion and proliferation of HCC cells. Similarly, the downregulation of miR‑424 in HCC cells significantly promoted the migration, invasion and proliferation of HCC cells. [ABSTRACT FROM AUTHOR]