Programmed death receptor(PD)-1 monoclonal antibody-induced acute immune hepatitis in the treatment ;of recurrent hepatocellular carcinoma after liver transplantation:a case report / 器官移植

ABSTRACT

Objective To explore the safety of programmed death receptor (PD)-1 monoclonal antibody for treatment of hepatocellular carcinoma (HCC)recurrence after liver transplantation.Methods Clinical data of 1 case with acute immune hepatitis induced by PD-1 monoclonal antibody (pembrolizumab)therapy for recurrent HCC after liver transplantation was retrospectively analyzed.Results The patient who received liver transplantation for primary HCC was diagnosed with lung metastasis at 4 months after the transplantation,and treated with the pembrolizumab (1 50 mg intravenous infusion of once)at 1 2 months after transplantation.Liver dysfunction was found at 5 th d after treatment,and liver biopsy was conducted which showed pathological changes of mild to moderate acute rejection.It was diagnosed to be acute immune hepatitis based on the patient 's clinical manifestations,laboratory examination and pembrolizumab drug instructions.After adrenal cortical hormone and intensive immunosuppressive therapy,the patient was followed up for 8 months,which showed that the patient survived with tumor,but the liver function remained abnormal.Conclusions PD-1 monoclonal antibody and other immune checkpoint inhibitors are not suitable for the immunologic suppression after liver transplantation due to the risk of inducing immune hepatitis.