肝癌患者肝移植术前使用PD-1抑制剂对移植后排斥反应的影响

目的:观察肝癌患者肝移植术前使用PD-1抑制剂对肝移植术后排斥反应的影响。方法:选取2019年1月1日至2019年12月31日在复旦大学附属中山医院行肝移植且移植前接受过PD-1抑制剂治疗的肝癌患者,共12例。检测其术后早期他克莫司药物浓度,观察移植术后排斥反应发生情况。结果:术后第1周和第2周他克莫司浓度分别为(5.14±2.68) ng/mL和(8.41±5.73) ng/mL。16.7%(2/12)患者发生细胞性排斥。结论:肝移植术前使用PD-1抑制剂的肝癌患者,其移植术后排斥反应的发生率未见明显增加。

The effect of PD-1 inhibitor treatment before liver transplantation on posttransplant rejection in liver cancer patients

Objective To explore the effect of PD-1 inhibitor treatment before liver transplantation on posttransplant rejection in liver cancer patients. Methods We analyzed the data of 12 patients with liver cancer who received PD-1 inhibitor before liver transplantation between January 1 and December 31 in 2019 in Zhongshan Hospital affiliated to Fudan University. The difference of tacrolimus concentration in the early stage after liver transplantation was analyzed. The correlations between the occurrence of organ rejection and the frequency of PD-1 inhibitor use or the time interval between the last use and liver transplantation was analyzed., Results The tacroliums concentration at 1week or 2 week after liver transplantation were 5.14±2.68ng/ml and 8.41±5.73ng/ml. The incidence of rejection after liver transplantation was only 16.7%, which was not more than that of literature report. The frequence of PD-1 use in patients with rejection and non-rejection were 3.50 ±3.54 and 6.50 ±5.79 respectively, with an OR of 0.86, P=0.495. The time interval between the last use and transplantation were 5.50 ±0.71 and 6.80 ±5.37, with an OR of 0.95, P=0.807. Conclusion Our preliminary results found the incidence of rejection after transplantation did not increased in patients with liver cancer who were treated with PD-1 inhibitor before liver transplantation. There was no significant correlation between the frequence of PD-1 inhibitor use and the interval time and the occurrence of rejection.