Evidence map›Paper›PMID 41193174›Full record

Observational studyGut2026

Immune-related adverse events are a potent predictor of post-transplant rejection in HCC: a multicentre retrospective cohort study.

Jun Fang, Siyi Zhong, Tielong Wang, Kang He, Aibo Mu, Meiching Ong, Yimou Lin, Zebin Zhu, Ning Wang, Jiancheng Wu and 9 more

Abstract readMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Gut, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed
–field-weighted citation impact
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

11 citing papers in PubMed.

  1. Review
  2. Review
  3. Review
  4. Article
  5. Review
  6. Review
  7. Review
  8. Review
  9. Review
  10. Review
  11. Review
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

19 authors.

Jun Fang *Department of Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Siyi Zhong *Department of Hepatobiliary and Pancreatic Surgery, Shulan (Hangzhou) Hospital, Hangzhou, China.
Tielong Wang *Organ Transplant Centre, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.
Kang He *Department of Liver Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.ORCID 0000-0003-4671-1337
Aibo MuDepartment of Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Meiching OngDepartment of Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Yimou LinOrgan Transplant Centre, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.
Zebin ZhuDepartment of Liver Transplantation, Organ Transplant Centre, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China.
Ning WangDepartment of Liver Transplantation, Organ Transplant Centre, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China.
Jiancheng WuDepartment of Liver Transplantation, Organ Transplant Centre, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China.
Zhihao WangOrgan Transplantation Clinical Medical Center of Xiamen University, Department of General Surgery, Xiang'an Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China.
Zhao LiDepartment of Hepatobiliary Surgery, Peking University People's Hospital, Beijing, China.
Feng GaoDepartment of Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Li ZhuangDepartment of Hepatobiliary and Pancreatic Surgery, Shulan (Hangzhou) Hospital, Hangzhou, China.
Zhiyong GuoOrgan Transplant Centre, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.
Shusen ZhengDepartment of Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.ORCID 0000-0003-1459-8261
Hao LiOrgan Transplantation Clinical Medical Center of Xiamen University, Department of General Surgery, Xiang'an Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China lingqi@zju.edu.cn zsg0517@ustc.edu.cn lihao6656@163.com.
Shugeng ZhangDepartment of Liver Transplantation, Organ Transplant Centre, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China lingqi@zju.edu.cn zsg0517@ustc.edu.cn lihao6656@163.com.
Qi LingDepartment of Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China lingqi@zju.edu.cn zsg0517@ustc.edu.cn lihao6656@163.com.ORCID 0000-0002-7377-2381

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundImmune checkpoint inhibitors (ICIs) enable successful hepatocellular carcinoma (HCC) downstaging or bridging for liver transplantation (LT) but increase allograft rejection risk. Although immune-related adverse events (irAEs) reflect immune activation during ICI therapy, their association with post-transplant rejection remains unclear.

objectiveWe aimed to identify the risk factors of rejection, focusing on irAEs.

designThis national multicentre retrospective study included 209 adult HCC patients who received pretransplant ICIs from 2018 to 2024. Logistic regression was performed to identify rejection factors and build a predictive model. A prospective observational cohort of 23 HCC patients was enrolled to explore the association between peripheral blood immunophenotype and irAEs.

resultsAmong 209 patients, 36 (17.2%) experienced rejection with a median time of 10 days post-LT. Multivariate analysis identified irAEs as the strongest predictor of rejection, with an OR of 9.170 (p<0.001). Other independent risk factors were recipient age <40 years (OR=3.028, p=0.049) and washout period <30 days (OR=3.071, p=0.018). The resulting predictive model achieved an area under the curve of 0.788. Moreover, patients with irAEs had significantly increased numbers of peripheral blood CD8

conclusionsThis study identified irAEs as a potent predictor of allograft rejection in HCC patients receiving pretransplant ICIs, potentially driven by heightened immune activation. The predictive model may help stratify patients at high risk of rejection.

Indexed as

Carcinoma, HepatocellularGraft RejectionImmune Checkpoint InhibitorsLiver NeoplasmsLiver TransplantationAdultAgedFemaleHumansMaleMiddle AgedRetrospective StudiesRisk FactorsImmune Checkpoint InhibitorsADVERSE DRUG REACTIONSHEPATOCELLULAR CARCINOMALIVER TRANSPLANTATIONPROGNOSIS

Identifiers

PMID41193174
PMCPMC13217134

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

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.