Evidence map›Paper›PMID 30255136›Full record

ArticleTransplantation direct2018

Liver Allograft Failure After Nivolumab Treatment-A Case Report With Systematic Literature Research.

Dimitri Gassmann, Stefan Weiler, Joachim C Mertens, Cäcilia S Reiner, Bart Vrugt, Mirjam Nägeli, Joanna Mangana, Beat Müllhaupt, Fabienne Jenni, Benjamin Misselwitz

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Transplantation direct, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 69 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
69citing papers in PubMed, 5 pooled it
6.5field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

69 citing papers in PubMed, 5 syntheses or guidelines pooled it, 134 citations in OpenAlex.

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  3. Immune checkpoint inhibitors in malignancies after liver transplantation: A systematic review and pooled analysis.Liver international : official journal of the International Association for the Study of the Liver · 2023
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9 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 1 institution in 1 country.

Dimitri GassmannDepartment of Internal Medicine, University Hospital Zurich and University of Zurich, Zürich, Switzerland.
Stefan WeilerDepartment of Clinical Pharmacology and Toxicology, University Hospital Zurich and University of Zurich, Zürich, Switzerland.
Joachim C MertensDepartment of Gastroenterology and Hepatology, University Hospital Zurich and University of Zurich, Zürich, Switzerland.
Cäcilia S ReinerInstitute of Diagnostic and Interventional Radiology, University Hospital Zurich and University of Zurich, Zürich, Switzerland.
Bart VrugtInstitute of Pathology and Molecular Pathology, University Hospital Zurich and University of Zurich, Zürich, Switzerland.
Mirjam NägeliDepartment of Dermatology, University Hospital Zurich and University of Zurich, Zürich, Switzerland.
Joanna ManganaDepartment of Dermatology, University Hospital Zurich and University of Zurich, Zürich, Switzerland.
Beat MüllhauptDepartment of Gastroenterology and Hepatology, University Hospital Zurich and University of Zurich, Zürich, Switzerland.
Fabienne JenniDepartment of Internal Medicine, University Hospital Zurich and University of Zurich, Zürich, Switzerland.
Benjamin MisselwitzDepartment of Gastroenterology and Hepatology, University Hospital Zurich and University of Zurich, Zürich, Switzerland.
University of Zurich · CH

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundOrthotopic liver transplantation (OLT) is a potential curative treatment in patients with hepatocellular carcinoma (HCC); however, treatment options for recurrent HCC after OLT are limited. Immune checkpoint inhibitors, such as nivolumab, an inhibitor of programmed cell death protein 1, have been successfully used for metastatic HCC but data on safety of nivolumab following solid organ transplantation are limited.

methodsWe report a 53-year-old woman with HCC who was treated with OLT. After 2 years, HCC recurred. Initial treatment with sorafenib was discontinued due to side effects and disease progression. Progressive HCC in the lung and lymph nodes was subsequently treated with nivolumab. One week after the first nivolumab dose, rapid progressive liver dysfunction was noted. Liver biopsy revealed severe cellular graft rejection prompting treatment with intravenous steroids and tacrolimus. Liver function continued to decline, leading to severe coagulopathy. The patient succumbed to intracranial hemorrhage.

resultsA systematic PubMed search revealed 29 cases treated with a checkpoint inhibitor following solid organ transplantation. Loss of graft was described in 4 (36%) of 11 cases with OLT and in 7 (54%) of 13 cases after kidney transplantation. However, cases with favorable outcome were also described. Eighteen cases with adverse events were identified upon searching the World Health Organization database VigiBase, including 2 cases with fatal outcome in liver transplant recipients due to graft loss.

conclusionExperience with checkpoint inhibitors in solid organ transplant recipients is limited. Published cases so far suggest severe risks for graft loss as high as 36% to 54%.

Identifiers

PMID30255136
PMCPMC6092180
OpenAlexW2883959012

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.