ArticleBMC medicine2025
Immune checkpoint inhibitors use in liver transplantation for hepatocellular carcinoma: a global cohort study.
Article in BMC medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Pretransplant Systemic Therapies for Hepatocellular Carcinoma: A Systematic Review of Posttransplant Outcomes.Journal of gastrointestinal cancer · 2026Pooled it
- Shrinking Giants: On the Feasibility of Downsizing Hepatocellular Carcinoma with Immunotherapy Prior to Liver Transplantation.Journal of clinical medicine · 2026Review
- Pathological Complete Response in Advanced Hepatocellular Carcinoma With Portal Vein Tumor Thrombus Following Conversion Therapy With TACE, HAIC, Lenvatinib, and Sintilimab: A Case Report.Clinical case reports · 2026Article
- Balancing Tumor Response and Rejection Risk After Pre-Transplant Immunotherapy: A Scoping Review.Cancers · 2026Review
- Predicting and Managing Hepatocellular Carcinoma Recurrence After Liver Transplant: A Single-Center Experience 2012-2024.Cancers · 2026Article
- Application of stem cells in the precise diagnosis and treatment of liver diseases.World journal of gastroenterology · 2025Review
- Transforming Liver Cancer Therapy: Integrating Molecular Profiling with Precision and Transplant-Based Care.Cancers · 2025Review
Corrections and comments
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Authors and funding
14 authors.
Funding
Abstract
backgroundHepatocellular carcinoma (HCC) remains a major contributor to global cancer mortality, with liver transplantation (LT) offering curative potential for patients in the early stages. While immune checkpoint inhibitors (ICIs) are effective in managing tumor progression, concerns about graft rejection persist. This study investigates how peri-LT ICIs administration affects rejection rates and survival outcomes in HCC patients.
methodsThis global study analyzed 386 HCC patients receiving Peri-LT ICIs therapy, integrating data from a systematic literature review and institutional registries. The risk of graft rejection and survival outcomes were assessed using logistic and Cox regression, along with restricted cubic splines modeling dose-response dynamics.
resultsOverall graft rejection rates did not significantly differ between Pre-LT (17.5%) and Post-LT (22.1%) ICI users (P = 0.351); however, Post-LT use was associated with higher rates of graft loss/dysfunction (47.1% vs. 25.9%, P < 0.05) and rejection-related mortality (47.1% vs. 18.5%, P < 0.05). In Pre-LT patients, washout periods >30 days (OR = 0.36, 95% CI: 0.18-0.72, P = 0.004) and >1.5 half-life counts (OR = 0.24, 95% CI: 0.12-0.50, P < 0.001) were associated with reduced rejection risk. Post-LT, high PD-L1 expression on graft tissue correlated with increased rejection risk (P < 0.001). Graft rejection following Pre-LT ICIs was linked to poorer overall survival (HR = 5.17, 95% CI: 2.21-12.24, P < 0.001).
conclusionsWith careful management, peri-LT ICIs may be considered for HCC patients. Optimizing washout periods and monitoring graft PD-L1 expression may improve transplant outcomes.
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