Liver Transplantation After Immune Checkpoint Inhibition in Hepatocellular Carcinoma—Data From the Multinational LITCHI Registry
Year: 2026
Type: article
Study design: Observational Study
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 (Liver transplantation after immune checkpoint inhibition) 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.
Source: Liver International
DOI: 10.1111/liv.70692
Authors: Ulrike Bauer, Maria R. Troppmair, Najib Ben Khaled, Julia M. Grottenthaler, Friedrich Foerster, Sena Blümel, Sophia Heinrich, Friedrich Sinner, Matthias Pinter, Magdalena Hahn, Florian van Bömmel, Bernhard Scheiner, Marino Venerito, Richard Taubert, Andreas E. Kremer, Arndt Weinmann, Christoph P. Berg, Christian M. Lange, Enrico N. De Toni, Angela Djanani, Heinz Zoller, Roland M. Schmid, Ursula Ehmer
Institutions: TUM Klinikum, Technical University of Munich, Innsbruck Medical University, Universität Innsbruck, LMU Klinikum, Ludwig-Maximilians-Universität München, Universitätsklinikum Tübingen, University of Tübingen, Johannes Gutenberg University Mainz, University Medical Center of the Johannes Gutenberg University Mainz, University of Zurich, University Hospital Zurich, Medizinische Hochschule Hannover, University Hospital Magdeburg, Otto-von-Guericke-Universität Magdeburg, Medical University of Vienna, University Hospital Leipzig, Leipzig University
Language: English
Subfield: Hepatology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,780
Funder: Roche
OpenAlex ID: W7161702399