Hepatocellular carcinoma (HCC) is one of the most common causes of cancer deaths worldwide. As most patients present with advanced disease, curative therapy such as surgical resection and radiofrequency ablation are rarely utilized. With the advent of immunotherapy, historical treatment approaches such as liver transplantation are being challenged. In particular, the use of immune checkpoint inhibitors (ICIs) has emerged as a safe and useful option in the treatment of HCC. However, there is concern over adverse effects, such as graft rejection and graft loss. This updated review discusses the role of immunotherapy in the pre- and post-transplantation setting and provides insights into the potential of immunotherapy as an adjunct to liver transplantation. We deliberate on the use of ICI in the setting of the Milan criteria as well as the University of California San Francisco’s expanded criteria for liver transplantation. Current data suggest that ICI has utility, especially in the pretransplantation setting. Nevertheless, larger, purposefully designed clinical trials are needed to clearly identify patients who will benefit most from ICI treatment in the transplant setting and determine parameters that will minimize the risk of graft rejection and maximize the benefits of this adjunct treatment.
肝细胞癌是全球癌症死亡最常见原因之一。由于多数患者确诊时已处于晚期，手术切除和射频消融等根治性疗法应用有限。随着免疫疗法的出现，肝移植等传统治疗方式正面临挑战。特别是免疫检查点抑制剂在肝细胞癌治疗中已成为安全有效的选择。然而，该疗法可能引发移植物排斥和移植物丢失等不良反应。本文通过最新综述探讨免疫疗法在肝移植围手术期的应用价值，并深入分析其作为肝移植辅助治疗的潜力。我们系统评估了免疫检查点抑制剂在米兰标准及加州大学旧金山分校肝移植扩展标准中的应用现状。现有数据表明，免疫检查点抑制剂具有临床应用价值，尤其在移植前治疗阶段。然而，仍需开展大规模针对性临床试验，以明确移植背景下最能受益于免疫检查点抑制剂治疗的患者群体，并确立既能最大限度降低移植物排斥风险、又能优化辅助治疗获益的临床参数。
肿瘤(癌症)患者之家