Prior to ABOi liver transplant with PD-1 inhibitor in patients with hepatocellular carcinoma: A case report

IF 1.6 4区医学 Q4 IMMUNOLOGY Transplant immunology Pub Date : 2024-07-02 DOI:10.1016/j.trim.2024.102079

Yipeng Pan , Jicheng Hu , Tao Li , Shanbin Zhang , Wanbang Zhou , Jiangbo Sun , Jianli Wang , Wei Li , Jian Xu

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Abstract

Background

Liver transplantation (LT) is a unique and effective method for treating end-stage liver diseases and acute liver failure, bringing hope to many patients with liver cancer. LT is currently widely used in the treatment of liver diseases. However, there have been no patients with liver cancer who have undergone ABO-incompatible (ABOi) LT after treatment with the programmed cell death protein 1 (PD-1) inhibitor reported in the literature.

Case presentation

A patient with liver cancer who received sintilimab injection, an anti-PD1 therapy, before LT was admitted in the transplantation centre. This patient underwent ABOi LT. The perioperative treatment strategy of this patient was reported. A desensitisation protocol was conducted urgently for the patient before operation, and the immunosuppression programme of LT was adjusted. After operation, isoagglutinin titer and liver function indicators were strictly monitored. The patient recovered well after operation, and no sign of rejection reaction was observed.

Conclusion

We reported a patient with hepatocellular carcinoma (HCC) who received PD-1 inhibitor treatment before operation and successfully underwent ABOi LT. The present case report provides novel insights into the perioperative management of utilizing PD-1 inhibitors prior to ABOi LT in patients diagnosed with hepatocellular carcinoma (HCC).

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肝细胞癌患者在 ABOi 肝移植前使用 PD-1 抑制剂：病例报告。

背景：肝移植（LT）是治疗终末期肝病和急性肝衰竭的一种独特而有效的方法，为许多肝癌患者带来了希望。目前，肝移植已被广泛用于治疗肝病。然而，也有少数肝癌患者在使用程序性细胞死亡蛋白1（PD-1）抑制剂后出现ABO不相容（ABOi）LT的病例报道：移植中心收治了一名肝癌患者，该患者在接受LT治疗前注射了抗PD1的辛替利马。该患者接受了 ABOi LT。报告了该患者的围手术期治疗策略。术前为患者紧急实施了脱敏方案，并调整了LT的免疫抑制方案。术后严格监测异凝集素滴度和肝功能指标。术后患者恢复良好，未发现排斥反应迹象：我们报告了一名肝细胞癌（HCC）患者在术前接受了 PD-1 抑制剂治疗，并成功接受了 ABOi LT。本病例报告为肝细胞癌（HCC）患者术前使用 PD-1 抑制剂进行 ABOi LT 的围手术期管理提供了新的见解。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Transplant immunology 医学-免疫学

CiteScore

2.10

自引率

13.30%

发文量

198

审稿时长

48 days

期刊介绍： Transplant Immunology will publish up-to-date information on all aspects of the broad field it encompasses. The journal will be directed at (basic) scientists, tissue typers, transplant physicians and surgeons, and research and data on all immunological aspects of organ-, tissue- and (haematopoietic) stem cell transplantation are of potential interest to the readers of Transplant Immunology. Original papers, Review articles and Hypotheses will be considered for publication and submitted manuscripts will be rapidly peer-reviewed and published. They will be judged on the basis of scientific merit, originality, timeliness and quality.