Our Summary

Immunotherapy, a type of treatment that uses the body’s immune system to fight diseases like cancer, has been very effective in treating advanced liver cancer (HCC). Recent studies have shown that combining immunotherapy with surgeries or local treatments can also be beneficial for patients with early or intermediate stages of HCC. Researchers are now questioning the role of immunotherapy for patients waiting to receive a liver transplant.

Liver transplantation is an effective treatment for HCC, as it replaces the diseased liver with a healthy one. Immunotherapy could potentially increase the success rate of reducing the size of the tumor and controlling its growth before the transplant. However, there are some risks. It could lead to immune-related side effects, which could be harmful for patients with chronic liver disease. It could also potentially lead to the body rejecting the new liver after transplantation.

The aim is to use immunotherapy to help more people become suitable for liver transplantation, without negatively affecting the outcomes before and after the transplant. This paper reviews the combination of immunotherapy, summarizes recent clinical trial results, and discusses the potential use of immunotherapy before liver transplantation in selected high-risk patients.

FAQs

  1. How can immunotherapy be helpful in treating advanced liver cancer?
  2. What are the potential risks of combining immunotherapy with liver transplantation?
  3. How can immunotherapy potentially increase the success rate of a liver transplant?

Doctor’s Tip

It is important to discuss the potential benefits and risks of immunotherapy with your healthcare team before considering it as a treatment option for liver transplant. It is also important to follow a healthy lifestyle, including maintaining a balanced diet, regular exercise, and avoiding alcohol and smoking, to improve your overall health and increase your chances of a successful liver transplant. Regular follow-up appointments and communication with your healthcare team are essential to monitor your progress and make any necessary adjustments to your treatment plan.

Suitable For

Patients who are typically recommended for liver transplant include those with end-stage liver disease, liver failure, liver cancer (such as hepatocellular carcinoma), and certain genetic liver diseases. Patients who have not responded to other treatments or who have a high risk of complications or death without a transplant may also be recommended for liver transplant.

Timeline

Before liver transplant:

  • Patient is diagnosed with liver cancer (HCC) and deemed eligible for liver transplant
  • Patient undergoes evaluation and testing to determine eligibility for transplant
  • Patient is placed on the transplant waiting list
  • Patient may undergo local treatments or surgeries to control tumor growth before transplant
  • Patient may receive immunotherapy to help reduce tumor size and control growth before transplant

After liver transplant:

  • Patient undergoes surgery to receive a new liver
  • Patient is closely monitored for signs of rejection or complications post-transplant
  • Patient may continue to receive immunotherapy or other treatments to prevent cancer recurrence
  • Patient undergoes regular follow-up appointments and monitoring to ensure the success of the transplant and monitor for any signs of recurrence or complications.

What to Ask Your Doctor

  1. How can immunotherapy benefit me as a liver transplant candidate with liver cancer?

  2. Are there any specific risks or side effects associated with combining immunotherapy with liver transplantation?

  3. What clinical trial results support the use of immunotherapy before liver transplantation in patients with HCC?

  4. How will immunotherapy impact my eligibility for a liver transplant and the success of the transplant surgery?

  5. What criteria are used to determine if I am a suitable candidate for immunotherapy before liver transplantation?

  6. How will immunotherapy be administered and monitored in conjunction with my liver cancer treatment and transplant process?

  7. What are the potential long-term effects of receiving immunotherapy before a liver transplant?

  8. How will immunotherapy affect my recovery and post-transplant care plan?

  9. Are there any alternative treatment options or considerations I should be aware of before deciding to pursue immunotherapy before liver transplantation?

  10. Can you provide me with more information or resources to help me better understand the role of immunotherapy in liver transplant candidates with HCC?

Reference

Authors: Li M, Bhoori S, Mehta N, Mazzaferro V. Journal: J Hepatol. 2024 Oct;81(4):743-755. doi: 10.1016/j.jhep.2024.05.037. Epub 2024 Jun 5. PMID: 38848767