Outcome of Kidney Transplant Patients Following Treatment with Checkpoint Inhibitors: A Case Series

Immune checkpoint inhibitors (ICIs) have revolutionized cancer treatment by enhancing immune surveillance against tumors. However, their use in kidney transplant recipients presents a significant challenge due to the risk of immune-mediated graft rejection. This retrospective case series highlights four kidney transplant recipients treated with ICIs for various malignancies, revealing the complex interplay between oncologic outcomes and transplant function. Two of four patients developed severe acute kidney injury (AKI), leading to dialysis-dependent graft loss despite high-dose corticosteroid therapy. One patient exhibited partial renal recovery following transient dialysis. In contrast, another patient maintained stable graft function despite prolonged ICI therapy. Oncologic outcomes varied, with two patients achieving significant tumor regression, while others experienced disease progression. These cases underscore the need for careful immunosuppressive management and close monitoring when administering ICIs in transplant recipients. The findings emphasize the importance of individualized treatment strategies to optimize both cancer control and graft survival.