器官移植2025，Vol.16Issue(3)：329-337,9.DOI:10.12464/j.issn.1674-7445.2025094
肝癌肝移植术前应用免疫检查点抑制剂治疗的进展
Progress in the preoperative use of immune checkpoint inhibitors in liver transplantation for hepatocellular carcinoma
摘要
Abstract
Liver transplantation is the most effective radical treatment for hepatocellular carcinoma(HCC),especially for patients with HCC complicated by cirrhosis.Since most patients are in an advanced stage of unresectable state when they are present,the preoperative downstaging treatment for liver transplantation in HCC is of great significance for increasing the opportunity for surgery,reducing the dropout rate from the liver transplant waiting list,and thereby lowering the postoperative recurrence rate.Currently,immune checkpoint inhibitor(ICI)-based combination immunotherapy and targeted therapy is the most effective treatment for preoperative downstaging in liver transplantation for HCC.However,the immunoenhancing effects of ICI may increase the risk of post-transplant rejection.Therefore,it is necessary to find a"critical point"that allows ICI to effectively inhibit tumor growth during preoperative downstaging treatment without causing severe rejection after transplantation.This article reviews the latest advances in preoperative ICI treatment protocols,efficacy assessment,indications,contraindications,drug discontinuation timing,and principles of prevention and treatment of rejection in liver transplantation for HCC.关键词
肝移植/肝癌/免疫检查点抑制剂/靶向治疗/降期治疗/桥接治疗/复发/排斥反应Key words
Liver transplantation/Hepatocellular carcinoma/Immune checkpoint inhibitor/Targeted therapy/Downstaging treatment/Bridge therapy/Recurrence/Rejection分类
临床医学引用本文复制引用
李文锋,李建华,王正昕..肝癌肝移植术前应用免疫检查点抑制剂治疗的进展[J].器官移植,2025,16(3):329-337,9.基金项目
国家重点研发计划(2021YFA1100500、2023YFC2505900) （2021YFA1100500、2023YFC2505900）
国家自然科学基金专项项目(82241225) （82241225）
国家自然科学基金面上项目(81873874、82071797) （81873874、82071797）
