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World J Gastrointest Pharmacol Ther. Sep 5, 2024; 15(5): 97570
Published online Sep 5, 2024. doi: 10.4292/wjgpt.v15.i5.97570
Downstaging of advanced hepatocellular carcinoma followed by liver transplantation using immune checkpoint inhibitors: Where do we stand?
Hirak Pahari, Javid A Peer, Shikhar Tripathi, Suresh K Singhvi, Ushast Dhir
Hirak Pahari, Suresh K Singhvi, Ushast Dhir, Department of Liver Transplant and Hepatobiliary Surgery, Sir Ganga Ram Hospital, New Delhi 110060, Delhi, India
Javid A Peer, Shikhar Tripathi, Department of Surgical Gastroenterology and Liver Transplant, Sir Ganga Ram Hospital, New Delhi 110060, Delhi, India
Author contributions: Pahari H and Peer JA devised the concept; Pahari H, Peer JA and Tripathi S performed the research and literature review; Tripathi S, Singhvi S and Dhir U completed the manuscript; Singhvi S and Dhir U prepared the tables and figure; Pahari H, Peer JA and Tripathi S reviewed and revised the manuscript.
Conflict-of-interest statement: All authors have no conflicts of interest to disclose.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hirak Pahari, DNB, MBBS, Surgeon, Department of Liver Transplant and Hepatobiliary Surgery, Sir Ganga Ram Hospital, Old Rajinder Nagar, New Delhi 110060, Delhi, India. hirak.pahari@gmail.com
Received: June 2, 2024
Revised: August 22, 2024
Accepted: August 28, 2024
Published online: September 5, 2024
Processing time: 92 Days and 15.3 Hours
Core Tip

Core Tip: The advent of immune checkpoint inhibitors as a downstaging therapy has been followed with great interest since the results of the IMBRAVE study, especially for multifocal hepatocellular carcinoma beyond criteria and certain cases with portal vein tumor thrombosis. Multiple case reports have shown benefit but with a degree of caution. Our review aims to identify the key points and recommendations for the safe usage of these life-saving immunomodulators in the setting of liver transplantation using the current available literature.