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How Long Should Immunotherapy Be Stopped Before Liver Transplant?

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Determining safe washout period for immune checkpoint inhibitors prior to liver transplantation An international retrospective cohort study DOI- 10.1097HEP.0000000000001289

Some people with advanced liver cancer (HCC) are treated with immunotherapy, known as immune checkpoint inhibitors (ICIs). These medicines help the body fight cancer. But if a liver transplant is needed later, doctors worry that immunotherapy might make the body reject the new liver.

This study looked at 119 people who had ICIs before getting a liver transplant. About 1 in 5 of them had problems with rejection after surgery. Most of these problems happened around 9 days after the transplant.

The timing between the last dose of immunotherapy and the transplant—called the washout period—made a big difference:

⦿ If the washout was less than 30 days, the risk of rejection was very high.

⦿ If the washout was 30 to 50 days, the risk was still high, but lower.

⦿ If the washout was more than 50 days, the risk was lowest.

People who waited more than 50 days had a much safer transplant and the same chance of staying cancer-free afterward.

If you’re on immunotherapy and planning for a liver transplant, talk with your doctor about the timing. Waiting at least 50 days after your last immunotherapy dose may help protect your new liver.

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