Fatal hepatic necrosis after nivolumab as a bridge to liver transplant for HCC: Are checkpoint inhibitors safe for the pretransplant patient?

Journal Article (Journal Article)

Nivolumab is an immune checkpoint inhibitor (ICI) currently in phase 3 clinical trials for hepatocellular carcinoma. The safety of ICIs in recipients of organ allotransplant is unclear, and several reports of fatal alloimmune injury after posttransplant ICI use have been published. We present the first published case of nivolumab used in the pretransplant setting for HCC resulting in fatal acute hepatic necrosis in the immediate postoperative period from a profound immune reaction likely propagated by nivolumab. Further investigation and significant caution are needed in the evaluation of patients awaiting transplant who are receiving ICI therapy.

Full Text

Duke Authors

Cited Authors

  • Nordness, MF; Hamel, S; Godfrey, CM; Shi, C; Johnson, DB; Goff, LW; O'Dell, H; Perri, RE; Alexopoulos, SP

Published Date

  • March 2020

Published In

Volume / Issue

  • 20 / 3

Start / End Page

  • 879 - 883

PubMed ID

  • 31550417

Electronic International Standard Serial Number (EISSN)

  • 1600-6143

International Standard Serial Number (ISSN)

  • 1600-6135

Digital Object Identifier (DOI)

  • 10.1111/ajt.15617


  • eng