器官移植2025，Vol.16Issue(6)：866-873,8.DOI:10.12464/j.issn.1674-7445.2025222
免疫检查点抑制剂在肾移植受者中的应用挑战与治疗前景
Application challenges and therapeutic prospects of immune checkpoint inhibitor in kidney transplant recipient
摘要
Abstract
Kidney transplant recipient(KTR)faces significant challenges in long-term survival,with the incidence of post-transplant malignancies being 2 to 3 times higher than that of the general population,making it the second leading cause of death in KTR.Immune checkpoint inhibitors(ICI)represent an important breakthrough in malignancy treatment,significantly improving the prognosis of some malignancy patients by blocking co-inhibitory signaling molecules and activating T lymphocyte activity.However,due to concerns about the risk of rejection,solid organ transplant recipients,including KTR,are usually excluded from ICI clinical trials.Existing evidence shows that the incidence of rejection during ICI treatment can be as high as 40%-50%,with the specific mechanisms not yet clear.Therefore,how to enable KTR to effectively benefit from the anti-tumor effects of ICI while avoiding rejection is crucial.This article focuses on the core contradiction of ICI in the treatment of post-transplant malignancies in KTR,that is,the dual effects of activating anti-tumor immunity and inducing transplant kidney rejection.It systematically reviews the current clinical application status and challenges,and explores optimization strategies for the delicate balance between restoring anti-tumor immunity and triggering rejection.关键词
免疫检查点抑制剂/肾移植/移植术后恶性肿瘤/急性排斥反应/程序性细胞死亡蛋白1/程序性细胞死亡蛋白配体1/细胞毒性T淋巴细胞相关抗原/移植后淋巴组织增殖性疾病Key words
Immune checkpoint inhibitor/Kidney transplantation/Post-transplantation malignancy/Acute rejection/Programmed cell death protein 1/Programmed cell death ligand 1/Cytotoxic T-lymphocyte-associated antigen/Post transplant lymphoproliferative disorder分类
医药卫生引用本文复制引用
陈传宝,巨春蓉,刘小友..免疫检查点抑制剂在肾移植受者中的应用挑战与治疗前景[J].器官移植,2025,16(6):866-873,8.基金项目
国家自然科学基金面上项目(82470103) （82470103）
