Liver Transplantation After Immune Checkpoint Inhibition in Hepatocellular Carcinoma—Data From the Multinational <scp>LITCHI</scp> Registry
ABSTRACT Evidence supporting the safety and efficacy of immune checkpoint inhibitors (ICI) before liver transplantation (LTx) in hepatocellular carcinoma (HCC) is increasing, but risks of graft rejection and tumour recurrence remain major concerns. We evaluated post‐transplant outcomes across 10 European centres using data from the multinational LITCHI ( Li ver t ransplantation after i mmune c heckpoint i nhibition) registry. Clinical and tumour characteristics, ICI regimens and post‐transplant immunosuppression were assessed, and overall and rejection‐free survival were estimated using the log‐rank test. Among 18 patients who underwent LTx following ICI, 15 were treated with atezolizumab plus bevacizumab. One‐year survival was 77% (95% CI 67.3–87.8) and four rejection episodes occurred, with one fatal case after a 13‐day wash‐out and three non‐fatal episodes, each responsive to escalation of immunosuppression. Overall, however, no intensified immunosuppression was required in our cohort. Despite tumour burden beyond Milan criteria in most patients before ICI initiation, HCC recurrence occurred in only one patient.
Authors
- Julia M. Grottenthaler (ORCID: https://orcid.org/0000-0001-9122-0962)
- Najib Ben Khaled (ORCID: https://orcid.org/0000-0002-9681-2542)
- Richard Taubert (ORCID: https://orcid.org/0000-0001-9270-2496)
- Ursula Ehmer
- Magdalena Hahn (ORCID: https://orcid.org/0000-0002-3195-6123)
- Matthias Pinter (ORCID: https://orcid.org/0000-0002-7260-532X)
- Marino Venerito (ORCID: https://orcid.org/0000-0001-8581-0974)
- Friedrich Sinner (ORCID: https://orcid.org/0000-0003-0524-8833)
- Florian van Bömmel (ORCID: https://orcid.org/0000-0003-2679-0672)
- Christoph P. Berg (ORCID: https://orcid.org/0000-0002-7318-9268)
- Sena Blümel (ORCID: https://orcid.org/0000-0002-0518-5505)
- Roland M. Schmid (ORCID: https://orcid.org/0000-0002-5751-7313)
- Heinz Zoller
- A E Kremer
- Ulrike Bauer
- Enrico N. De Toni (ORCID: https://orcid.org/0000-0002-8101-8207)
- Maria R. Troppmair (ORCID: https://orcid.org/0000-0003-4515-0523)
- Sophia Heinrich (ORCID: https://orcid.org/0000-0002-3650-2921)
- Christian M. Lange
- Angela Djanani
- Bernhard Scheiner (ORCID: https://orcid.org/0000-0002-4904-5133)
- Friedrich Foerster (ORCID: https://orcid.org/0000-0002-3234-8891)
- Arndt Weinmann (ORCID: https://orcid.org/0000-0003-1198-1716)
Institutions
- Innsbruck Medical University (AT)
- Johannes Gutenberg University Mainz (DE)
- University of Zurich (CH)
- LMU Klinikum (DE)
- Medizinische Hochschule Hannover (DE)
- University Medical Center of the Johannes Gutenberg University Mainz (DE)
- University Hospital of Zurich (CH)
- Centre de Coopération Universitaire Franco-Bavarois (DE)
- STZ eyetrial (DE)
- Tumkur University (IN)
- Medical University of Vienna (AT)
- University of Tübingen (DE)
- Ludwig-Maximilians-Universität München (DE)
- Leipzig University (DE)
- Otto-von-Guericke-Universität Magdeburg (DE)
Publication Details
- Journal
- Liver International
- Published
- 2026-05-19
- DOI
- https://doi.org/10.1111/liv.70692
- Primary Topic
- Hepatocellular Carcinoma Treatment and Prognosis
- Type
- article
- Field-Weighted Citation Impact
- 0.00