pISSN 2671-8790 eISSN 2671-8804

View

Article View

Korean J Transplant 2022; 36(2): 82-98

Published online June 30, 2022

https://doi.org/10.4285/kjt.22.0013

© The Korean Society for Transplantation

Immune checkpoint inhibitors for solid organ transplant recipients: clinical updates

Shun Kawashima1 , Kole Joachim1 , Maen Abdelrahim2 , Ala Abudayyeh3 , Kenar D. Jhaveri4,5 , Naoka Murakami1

1Transplantation Research Center, Division of Renal Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
2Section of GI Oncology, Department of Medical Oncology, Houston Methodist Cancer Center, Houston, TX, USA
3Section of Nephrology, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
4Division of Kidney Diseases and Hypertension, Donald and Barbara Zucker School of Medicine at Hofstra/ Northwell, Great Neck, NY, USA
5Department of Internal Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY, USA

Correspondence to: Naoka Murakami
Transplantation Research Center, Division of Renal Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, 221 Longwood Avenue, Boston, MA 02115, USA
Tel: +1-617-732-5847
Fax: +1-617-732-5254
E-mail: nmurakami1@bwh.harvard.edu

Received: March 21, 2022; Revised: April 21, 2022; Accepted: April 26, 2022

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Transplant care continues to advance with increasing clinical experience and improvements in immunosuppressive therapy. As the population ages and long-term survival improves, transplant patient care has become more complex due to comorbidities, frailty, and the increased prevalence of cancer posttransplantation. Immune checkpoint inhibitors (ICIs) have become a standard treatment option for many cancers in non-transplant patients, but the use of ICIs in transplant patients is challenging due to the possibility of disrupting immune tolerance. However, over the past few years, ICIs have gradually started to be used in transplant patients as well. In this study, we review the current use of ICIs after all solid organ transplantation procedures (kidney, liver, heart, and lung). Increasing data suggest that the type and number of immunosuppressants may affect the risk of rejection after immunotherapy. Immunotherapy for cancer in transplant patients may be a feasible option for selected patients; however, prospective trials in specific organ transplant recipients are needed.

Keywords: Immune checkpoint inhibitor, Transplantation, Graft rejection, Programmed cell death protein 1, Cytotoxic T-lymphocyte-associated protein 4

HIGHLIGHTS
  • Immunotherapy for cancer in transplant patients is becoming more common, as immunotherapy has received Food and Drug Administration approval for more cancers.

  • Immunotherapy for solid organ transplant recipients is challenging due to a higher risk of rejection.

  • Prospective clinical studies investigating the optimal adjustment of immunosuppressants are awaited.