Liver transplantation for hepatocellular carcinoma following checkpoint inhibitor therapy with nivolumab

Autor: Gabriel T. Schnickel, Kassandra Fabbri, Mojgan Hosseini, Michael Misel, Jennifer Berumen, Justin Parekh, Kristin Mekeel, Yalda Dehghan, Yuko Kono, Veeral Ajmera
Rok vydání: 2022
Předmět:
liver allograft function/dysfunction
liver allograft function
Carcinoma
Hepatocellular
adjuvant therapy [cancer/malignancy/neoplasia]
cancer/malignancy/neoplasia
Clinical Trials and Supportive Activities
complication
clinical research/practice
medical
Medical and Health Sciences
Article
Necrosis
Rare Diseases
Clinical Research
metabolic
medical/metabolic [complication]
Immunology and Allergy
Humans
cancer
Pharmacology (medical)
Retrospective Studies
Aged
clinical decision-making
Transplantation
dysfunction
liver transplantation
Liver Disease
Carcinoma
Liver Neoplasms
Evaluation of treatments and therapeutic interventions
Hepatocellular
adjuvant therapy
Organ Transplantation
Middle Aged
practice
Liver Transplantation
neoplasia
Nivolumab
Good Health and Well Being
6.1 Pharmaceuticals
hepatology
Surgery
Digestive Diseases
liver transplantation/hepatology
malignancy
Zdroj: American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons, vol 22, iss 6
Am J Transplant
Popis: Limited case series describe conflicting results regarding the safety of checkpoint inhibitors (CPI) prior to liver transplantation (LT). We reviewed single-center data on all consecutive patients who underwent LT for hepatocellular carcinoma treated with CPI between January 1, 2018, and January 30, 2021. Time from CPI to LT, immunosuppression, biopsy-proven acute cellular rejection (BPACR), graft loss and death were evaluated. Five patients with a mean age 65 (range 61-71) years underwent LT after CPI with nivolumab. Time from last CPI to LT ranged from 0.3 to 11months. Two patients with 3months from the last dose of CPI had BPACR. In conclusion, pretransplant use of CPIs, particularly within 90days of LT, was associated with BPACR and immune-mediated hepatic necrosis. Future multicenter studies should consider a sufficient interval from the last dose of CPI to LT to mitigate the risk for adverse immune-mediated outcomes and graft loss.
Databáze: OpenAIRE
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