Immunotherapy after liver transplantation:Where are we now?

作     者：Kin Pan Au Kenneth Siu Ho Chok 

作者机构：Department of SurgeryQueen Mary HospitalThe University of Hong KongHong KongChina Department of Surgery and State Key Laboratory for Liver ResearchThe University of Hong KongHong KongChina 

出 版 物：《World Journal of Gastrointestinal Surgery》 (世界胃肠外科杂志（英文版）（电子版）)

年 卷 期：2021年第13卷第10期

页      面：1267-1278页

核心收录：

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

主　　题：Liver transplant Hepatocellular carcinoma Recurrence Immunotherapy Rejection Survival 

摘      要：BACKGROUND There is limited evidence on the safety of immunotherapy use after liver transplantation and its efficacy in treating post-liver transplant hepatocellular carcinoma(HCC)*** To assess the safety of immunotherapy after liver transplant and its efficacy in treating post-liver transplant HCC *** A literature review was performed to identify patients with prior liver transplantation and subsequent *** reviewed the rejection rate and risk factors of *** patients treated for HCC,the oncological outcomes were evaluated including objective response rate,progression-free survival(PFS),and overall survival(OS).RESULTS We identified 25 patients from 16 publications and 3 patients from our institutional database(total n=28).The rejection rate was 32%(n=9).Early mortality occurred in 21%(n=6)and was mostly related to acute rejection(18%,n=5).Patients who developed acute rejection were given immunotherapy earlier after transplantation(median 2.9 years vs 5.3 years,P=0.02)and their graft biopsies might be more frequently programmed death ligand-1-positive(100%vs 33%,P=0.053).Their PFS(1.0±0.1 mo vs 3.5±1.1 mo,P=0.02)and OS(1.0±0.1 mo vs 19.2±5.5 mo,P=0.001)compared inferiorly to patients without *** the 19 patients treated for HCC,the rejection rate was 32%(n=6)and the overall objective response rate was 11%.The median PFS and OS were 2.5±1.0 mo and 7.3±2.7 mo after *** Rejection risk is the major obstacle to immunotherapy use in liver transplant *** studies on the potential risk factors of rejection are warranted.