Practical Journal of Organ Transplantation(Electronic Version) ›› 2025, Vol. 13 ›› Issue (5): 437-442.DOI: 10.3969/j.issn.2095-5332.2025.05.010

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The correlation between immunotherapy and graft rejection risk in patients with hepatocellular carcinoma: A cohort study and literature review 

Wang Jun,Qu Wei,Zeng Zhigui,Wei Lin,Sun Liying,Zhu Zhijun.    

  1. Liver Transplantation Center, National Clinical Research Center for Digestive Diseases, Beijing Friendship Hospital, Capital Medical University ; Clinical Center for Pediatric Liver Transplantation, Capital Medical University ; State Key Lab of Digestive Health ; Laboratory for Clinical Medicine, Capital Medical University ; Beijing Key Laboratory of Tolerance Induction and Organ Protection in Transplantatio,Beijing 101100,China.

  • Online:2025-09-20 Published:2025-09-20

肝移植患者免疫治疗与移植物排斥反应的相关性:队列研究及文献复习

王君,曲伟,曾志贵,魏林,孙丽莹,朱志军   

  1. 首都医科大学附属北京友谊医院肝脏移植中心,国家消化系统疾病临床医学研究中心,首都医科大学肝脏免疫与器官保护联合实验室,北京 101100

Abstract:

Objective To explore the association between immune therapy and the risk of rejection after liver transplantation in patients with hepatocellular carcinoma (HCC). Methods A retrospective analysis was conducted on 11 HCC patients who received immune therapy before transplantation at Beijing Friendship Hospital from 2019 to 2025, and 70 cases reported in the literature were included. The incidence of rejection and influencing factors were analyzed. Results The rejection rate in our center's cohort was 9.1% 1/11), which was lower than that in theneoadjuvant therapy cohort 25.0%)and the post-transplantation cohort 30.8%)in the literature. The rejection rate was significantly reduced when the interval between the last dose of immune therapy and transplantation was more than two halflives. The expression of programmed death ligand 1(PD-L1)in the graft may be related to the risk of rejection and could serve as a potential biomarker for predicting rejection. Conclusion It is recommended to wait at least 8 weeks (two halflives)after immune therapy before liver transplantation. The expression levels of programmed death receptor 1(PD-1)/PDL1 in the graft tissue can be used as potential biomarkers, but further research is needed to explore the mechanism and safe time intervas. 

Key words:

Hepatocellular carcinoma; , Immunotherapy; , Liver transplantation; , Immune checkpoint inhibitors

摘要:

目的 探讨肝细胞癌(hepatocellular carcinoma,HCC)患者接受免疫治疗与肝移植术后排斥反应风险的关联性。方法 回顾性分析 2019 — 2025 年首都医科大学附属北京友谊医院 11 例移植前接受免疫治疗的 HCC 患者,并纳入文献报道的 70 例病例,分析排斥反应发生率及影响因素。结果 本中心队列排斥率为 9.1%1/11 人),低于文献中新辅助治疗队列(25.0%)和移植后队列(30.8%)。免疫治疗的末次用药与移植时间间隔> 2 个半衰期者排斥率显著降低。移植物中程序性死亡配体 1(programmed death ligand 1,PDL1)的表达可能与排斥风险相关,可作为预测排斥反应发生的潜在生物标志物。结论 建议免疫治疗后至少等待 8 周(2 个半衰期)再行肝移植。移植物组织中程序性死亡受体 1(programmed death receptor 1,PD-1)/PD-L1 的表达水平可作为潜在生物标志物,但需进一步研究其机制及安全时间间隔。

关键词: HCC , 免疫治疗 , 肝移植 , 免疫检查点抑制剂