{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T18:29:28Z","timestamp":1783967368765,"version":"3.55.0"},"reference-count":24,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T00:00:00Z","timestamp":1770163200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T00:00:00Z","timestamp":1770163200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Immune checkpoint inhibitors (ICIs) have emerged as promising agents for the management of advanced HCC. By reducing tumour burden, ICIs may serve as a downstaging\/bridging tool to improve transplant candidacy. The aim of this study was to assess the safety of patients receiving pre\u2010LT ICIs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Multicenter, retrospective cohort study from January 2018 to December 2024, including 48 patients who received ICIs prior to LT (ICI cohort). A control cohort (non\u2010ICI cohort) was built (1:3) using propensity score matching including 144 patients who underwent LT for HCC without prior ICI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Within the ICI cohort (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u200948) rejection occurred in 9 patients (18.8%), all biopsy\u2010proven, with a median onset of 31\u2009days post\u2010LT (12.0\u2013182.0). The median washout period was 60\u2009days (13\u201396). Patients experiencing rejection had shorter washout periods (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.029). All rejection episodes were successfully managed; two were steroid\u2010resistant, one requiring re\u2010transplantation. There were no rejection\u2010related deaths. Of the 5 patients with HCC recurrence, 60% received ICI for &lt;\u200990\u2009days (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.027). Comparison between the ICI and non\u2010ICI cohort revealed no significant differences in rejection rates (18.8% vs. 19.4%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.916), graft failure, HCC recurrence, or overall mortality. Overall survival (OS) did not differ between ICI and non\u2010ICI patients (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.625) or between those with and without rejection (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.119). Rejection was not associated with increased mortality, with deaths primarily attributed to infection or HCC recurrence.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our results demonstrate that rejection rates were similar in patients receiving ICIs pre\u2010LT and it can be safely managed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/apt.70528","type":"journal-article","created":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T07:44:58Z","timestamp":1770277498000},"page":"1369-1379","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Safety of Immune Checkpoint Inhibitors Prior to Liver Transplantation in Hepatocellular Carcinoma"],"prefix":"10.1111","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5414-2408","authenticated-orcid":false,"given":"L.","family":"Aceituno","sequence":"first","affiliation":[{"name":"Multi\u2010Organ Transplant, Toronto General Hospital University Health Network  Toronto Ontario Canada"},{"name":"Departament de Medicina Universitat Aut\u00f2noma de Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4570-949X","authenticated-orcid":false,"given":"C.","family":"Magyar","sequence":"additional","affiliation":[{"name":"Multi\u2010Organ Transplant, Toronto General Hospital University Health Network  Toronto Ontario Canada"},{"name":"University Health Network, HPB Surgical Oncology  Toronto Ontario Canada"},{"name":"Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital University of Bern  Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Tabrizian","sequence":"additional","affiliation":[{"name":"Department of Surgery Icahn School of Medicine at Mount Sinai  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Marino","sequence":"additional","affiliation":[{"name":"Department of Surgery Icahn School of Medicine at Mount Sinai  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Watt","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Medicine Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Chascsa","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Medicine Mayo Clinic  Phoenix Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Schnickel","sequence":"additional","affiliation":[{"name":"Division of Transplant and Hepatobiliary Surgery University of California, San Diego School of Medicine  San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V.","family":"Banz","sequence":"additional","affiliation":[{"name":"Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital University of Bern  Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"Alconchel","sequence":"additional","affiliation":[{"name":"Unit of HPB Surgery and Transplantation Virgen de la Arrixaca University Hospital (IMIB\u2010Pascual Parrilla)  Murcia Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Celia","family":"Martagon","sequence":"additional","affiliation":[{"name":"Unit of HPB Surgery and Transplantation Virgen de la Arrixaca University Hospital (IMIB\u2010Pascual Parrilla)  Murcia Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2367-2742","authenticated-orcid":false,"given":"C.","family":"Moctezuma","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology (Liver Unit) University of Alberta  Edmonton Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"Baker","sequence":"additional","affiliation":[{"name":"Huntsman Cancer Center University of Utah Eccles School of Medicine  Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Nwaduru","sequence":"additional","affiliation":[{"name":"Huntsman Cancer Center University of Utah Eccles School of Medicine  Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F. J.","family":"Krendl","sequence":"additional","affiliation":[{"name":"Department of Visceral, Transplant and Thoracic Surgery, Center for Operative Medicine Medical University of Innsbruck  Innsbruck Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Oberhuber","sequence":"additional","affiliation":[{"name":"Department of Visceral, Transplant and Thoracic Surgery, Center for Operative Medicine Medical University of Innsbruck  Innsbruck Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Ruiz\u2010Ortega","sequence":"additional","affiliation":[{"name":"Liver Unit, Hospital Universitari Vall D'hebron  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Demers","sequence":"additional","affiliation":[{"name":"University Health Network, HPB Surgical Oncology  Toronto Ontario 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