Immunotherapy in liver transplantation for hepatocellular carcinoma:Pros and cons

作     者：Yi Luo Fei Teng Hong Fu Guo-Shan Ding 

作者机构：Department of Liver Surgery and Organ TransplantationChangzheng HospitalNaval Medical UniversityShanghai 200003China 

出 版 物：《World Journal of Gastrointestinal Oncology》 (世界胃肠肿瘤学杂志（英文版）（电子版）)

年 卷 期：2022年第14卷第1期

页      面：163-180页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

基　　金：National Natural Science Foundation of China No.81702923 and No.81871262 

主　　题：Hepatocellular carcinoma Liver transplantation Immunotherapy Immune checkpoint inhibitors Adoptive cell transfer Immunosuppressant 

摘      要：Liver transplantation(LT)has emerged as a curative strategy for hepatocellular carcinoma(HCC),but contributes to a higher predisposition to HCC recurrence in the immunosuppression context,especially for tumors beyond the Milan *** immunotherapy has dramatically improved survival for immunocompetent patients and has become the standard of care for a variety of tumors,including HCC,it is mainly used outside the scope of organ transplantation owing to potentially fatal allograft ***,accumulative evidence has expanded the therapeutic paradigms of immunotherapy for HCC,from downstaging or bridging management in the pretransplant setting to the salvage or adjuvant strategy in the posttransplant ***,immunotherapy mainly includes immune checkpoint inhibitors(ICIs),adoptive cell transfer(ACT)and vaccine ***,followed by ACT,have been most investigated in LT,with some promising *** of the complex tumor microenvironment and immunoreactivity when immunosuppressants are combined with immunotherapy,it is difficult to reach formulations for immunosuppressant adjustment and the optimal selection of immunotherapy as well as *** addition,the absence of effective biomarkers for identifying rejection and tumor response is still an unresolved barrier to successful clinical immunotherapy applications for *** this review,we comprehensively summarize the available evidence of immunotherapy used in LT that is specific to ***,we discuss clinically concerning issues regarding the concurrent goals of graft protection and antitumor response.