{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T21:12:43Z","timestamp":1778188363266,"version":"3.51.4"},"reference-count":23,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"C","license":[{"start":{"date-parts":[[2024,10,1]],"date-time":"2024-10-01T00:00:00Z","timestamp":1727740800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2024,10,1]],"date-time":"2024-10-01T00:00:00Z","timestamp":1727740800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2024,9,9]],"date-time":"2024-09-09T00:00:00Z","timestamp":1725840000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002858","name":"China Postdoctoral Science Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002858","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction and importance:<\/jats:title>\n                    <jats:p>Graft-versus-host disease (GvHD) is a rare but severe complication following liver transplantation (LT), occurring in 1\u20102 % of cases with a mortality rate exceeding 80 %. Immune checkpoint inhibitors (ICIs) used pretransplant are associated with increased allograft rejection risk, but their impact on GvHD in LT remains unclear. Dominant one-way donor-recipient human leukocyte antigen (HLA) matching is a known risk factor for GvHD. This report presents a rare case of fatal GvHD in a hepatocellular carcinoma (HCC) patient treated with PD-1 inhibitors before LT and transplanted with a liver graft from a deceased donor with donor-dominant one-way HLA matching.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation:<\/jats:title>\n                    <jats:p>A 59-year-old male with a 30-year history of hepatitis B and unresectable HCC underwent LT after receiving the last dose of PD-1 inhibitors 7 days prior to the transplant. On post-operative day (POD) 12, the patient developed a skin rash, fever, and vomiting, and was diagnosed with GvHD. Despite aggressive treatment, including high-dose corticosteroids and extracorporeal membrane oxygenation (ECMO), the patient succumbed to gastrointestinal bleeding and multi-organ failure on POD 30. HLA genotyping revealed typical donor-dominant one-way HLA matching.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical discussion:<\/jats:title>\n                    <jats:p>This case highlights a potential link between pretransplant exposure to ICIs and GvHD, particularly with donor-dominant one-way HLA matching. Residual anti-PD-1 antibodies may activate graft-resident immune cells, precipitating GvHD. Further research with larger cohorts and animal models is required to clarify this relationship and understand the underlying mechanisms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Besides allograft rejection, caution should also be exercised regarding GvHD in patients with prior exposure to ICIs before LT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1016\/j.ijscr.2024.110267","type":"journal-article","created":{"date-parts":[[2024,9,10]],"date-time":"2024-09-10T04:05:36Z","timestamp":1725941136000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":3,"title":["Fatal graft-versus-host disease in recipient with pretransplant exposure to immune checkpoint inhibitors and donor-dominant one-way HLA matching after liver transplantation: A case report"],"prefix":"10.1097","volume":"123","author":[{"given":"Li","family":"Pang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wen-Rui","family":"Wu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lei-Bo","family":"Xu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chao","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"R1-94-20260507","doi-asserted-by":"crossref","DOI":"10.1097\/00007890-200301150-00022","article-title":"Liver transplant-associated graft-versus-host disease","volume":"75","author":"Smith,","year":"2003","journal-title":"Transplantation"},{"key":"R2-94-20260507","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1002\/lt.26318","article-title":"Acute graft-versus-host disease after orthotopic liver transplantation: predicting this rare complication using machine learning","volume":"28","author":"Cooper,","year":"2022","journal-title":"Liver Transpl."},{"key":"R3-94-20260507","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1097\/01.TP.0000103721.29729.FE","article-title":"Monitoring systemic donor lymphocyte macrochimerism to aid the diagnosis of graft-versus-host disease after liver transplantation","volume":"77","author":"Taylor,","year":"2004","journal-title":"Transplantation"},{"key":"R4-94-20260507","doi-asserted-by":"crossref","first-page":"466","DOI":"10.1111\/j.1600-6143.2004.00406.x","article-title":"Acute graft versus host disease following liver transplantation: the enemy within","volume":"4","author":"Taylor,","year":"2004","journal-title":"Am. J. Transplant."},{"key":"R5-94-20260507","doi-asserted-by":"crossref","first-page":"406","DOI":"10.6004\/jnccn.2022.7009","article-title":"Immune checkpoint inhibitor use in solid organ transplant recipients: a systematic review","volume":"20","author":"Portuguese,","year":"2022","journal-title":"J. Natl. Compr. Canc. Netw."},{"key":"R6-94-20260507","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1111\/liv.15474","article-title":"Immune checkpoint inhibitors in malignancies after liver transplantation: better safe or sorry?","volume":"43","author":"Vogel,","year":"2023","journal-title":"Liver Int."},{"key":"R7-94-20260507","doi-asserted-by":"crossref","DOI":"10.1097\/LVT.0000000000000083","article-title":"Neoadjuvant programmed cell death 1 inhibitor before liver transplantation for HCC is not associated with increased graft loss","volume":"29","author":"Wang,","year":"2023","journal-title":"Liver Transpl."},{"key":"R8-94-20260507","doi-asserted-by":"crossref","first-page":"878","DOI":"10.1016\/j.transproceed.2023.03.064","article-title":"Optimizing the safe washout period for liver transplantation following immune checkpoint inhibitors with atezolizumab, nivolumab, or pembrolizumab","volume":"55","author":"Kuo,","year":"2023","journal-title":"Transplant. Proc."},{"key":"R9-94-20260507","doi-asserted-by":"crossref","first-page":"1141","DOI":"10.21037\/jgo-22-922","article-title":"Immune checkpoint inhibitors in liver transplant: a case series","volume":"14","author":"Rudolph,","year":"2023","journal-title":"J. Gastrointest. Oncol."},{"key":"R10-94-20260507","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1002\/lt.20573","article-title":"Fatal graft-versus-host disease after living donor liver transplantation: differential impact of donor-dominant one-way HLA matching","volume":"12","author":"Kamei,","year":"2006","journal-title":"Liver Transpl."},{"key":"R11-94-20260507","doi-asserted-by":"crossref","first-page":"460","DOI":"10.1002\/lt.20101","article-title":"Graft-versus-host disease following living donor liver transplantation","volume":"10","author":"Soejima,","year":"2004","journal-title":"Liver Transpl."},{"key":"R12-94-20260507","doi-asserted-by":"crossref","first-page":"1063","DOI":"10.1111\/ctr.12627","article-title":"Graft-versus-host disease after orthotopic liver transplantation: multivariate analysis of risk factors","volume":"29","author":"Elfeki,","year":"2015","journal-title":"Clin. Transplant."},{"key":"R13-94-20260507","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1097\/MEG.0b013e3283652b66","article-title":"Hangzhou criteria for liver transplantation in hepatocellular carcinoma: a single-center experience","volume":"26","author":"Lei,","year":"2014","journal-title":"Eur. J. Gastroenterol. Hepatol."},{"key":"R14-94-20260507","doi-asserted-by":"crossref","DOI":"10.1016\/j.transproceed.2024.05.041","article-title":"Downstaging of hepatocellular carcinoma before liver transplantation: current advances in selection criteria and therapeutic options","author":"Pang,","year":"2024","journal-title":"Transplant. Proc."},{"key":"R15-94-20260507","doi-asserted-by":"crossref","first-page":"733","DOI":"10.1097\/01.TP.0000053401.91094.CA","article-title":"Unusual onset of chronic graft-versus-host disease after adult living-related liver transplantation from a homozygous donor","volume":"75","author":"Nemoto,","year":"2003","journal-title":"Transplantation"},{"key":"R16-94-20260507","first-page":"5240","article-title":"Graft-versus-host disease after liver transplantation: a comprehensive literature review","volume":"18","author":"Akbulut,","year":"2012","journal-title":"World J. Gastroenterol."},{"key":"R17-94-20260507","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1016\/j.bbmt.2018.08.028","article-title":"Significant risk of graft-versus-host disease with exposure to checkpoint inhibitors before and after allogeneic transplantation","volume":"25","author":"Ijaz,","year":"2019","journal-title":"Biol. Blood Marrow Transplant."},{"key":"R18-94-20260507","doi-asserted-by":"crossref","first-page":"1268","DOI":"10.1038\/bmt.2016.111","article-title":"Fatal GvHD induced by PD-1 inhibitor pembrolizumab in a patient with Hodgkin's lymphoma","volume":"51","author":"Singh,","year":"2016","journal-title":"Bone Marrow Transplant."},{"key":"R19-94-20260507","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1182\/blood-2020-139614","article-title":"Lower risk of graft versus host disease after exposure to checkpoint inhibitors with the use of post-transplant cyclophosphamide prophylaxis","volume":"136","author":"Saberian,","year":"2020","journal-title":"Blood"},{"key":"R20-94-20260507","doi-asserted-by":"crossref","DOI":"10.1016\/j.intimp.2022.109051","article-title":"Blockade of PD-1\/PD-L1 increases effector T cells and aggravates murine chronic graft-versus-host disease","volume":"110","author":"Liang,","year":"2022","journal-title":"Int. Immunopharmacol."},{"key":"R21-94-20260507","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1097\/01.tp.0000268074.77929.54","article-title":"PD-1-PD-L1 pathway is involved in suppressing alloreactivity of heart infiltrating T cells during murine GVHD across minor histocompatibility antigen barriers","volume":"84","author":"Schilbach,","year":"2007","journal-title":"Transplantation"},{"key":"R22-94-20260507","doi-asserted-by":"crossref","first-page":"4081","DOI":"10.1182\/bloodadvances.2019000134","article-title":"PTCy ameliorates GVHD by restoring regulatory and effector T-cell homeostasis in recipients with PD-1 blockade","volume":"3","author":"Ikegawa,","year":"2019","journal-title":"Blood Adv."},{"key":"R23-94-20260507","doi-asserted-by":"crossref","first-page":"1136","DOI":"10.1097\/JS9.0000000000000373","article-title":"The SCARE 2023 guideline: updating consensus surgical CAse REport (SCARE) guidelines","volume":"109","author":"Sohrabi,","year":"2023","journal-title":"Int. J. Surg."}],"container-title":["International Journal of Surgery Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2210261224010484?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2210261224010484?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.lww.com\/10.1016\/j.ijscr.2024.110267","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T21:00:20Z","timestamp":1778187620000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1016\/j.ijscr.2024.110267"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10]]},"references-count":23,"journal-issue":{"issue":"C","published-print":{"date-parts":[[2024]]}},"URL":"https:\/\/doi.org\/10.1016\/j.ijscr.2024.110267","relation":{},"ISSN":["2210-2612"],"issn-type":[{"value":"2210-2612","type":"print"}],"subject":[],"published":{"date-parts":[[2024,10]]},"assertion":[{"value":"2024-08-03","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-09-06","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}