Liver transplantation represents a curative treatment option for patients with hepatocellular carcinoma complicated by cirrhosis. In the era of immunotherapy, liver transplantation for hepatocellular carcinoma has exhibited novel characteristics: (1) Immune-based therapies facilitate tumor downstaging or serve as a bridge to transplantation in an increasing number of patients, thereby broadening the pool of eligible recipients; (2) While these therapies improve post-transplant outcomes, they are concurrently associated with an elevated incidence of postoperative rejection. Refractory rejection and infectious complications pose major clinical challenges in this context—the former constitutes a key difficulty in liver transplantation during the immunotherapy era, whereas the latter remains the leading cause of perioperative mortality following liver transplantation.
The dynamic complexity of the immune response following liver transplantation underpins the fundamental interplay between infection and rejection, which represents a major challenge in postoperative management. Insufficient immunosuppression may trigger rejection, whereas excessive immunosuppression heightens the risk of infection. Overcoming this challenge necessitates a comprehensive understanding of the longitudinal immune evolution in liver transplant recipients. To achieve this, the present topic aims to integrate multi-center clinical cohort data from liver cancer patients undergoing liver transplantation with multi-omics technologies, including therapeutic strategy based on immune modulation, anti-infective interventions, and stratified organ support. This topic will enable the development of a precision intervention framework encompassing risk prediction, prevention, and management. Ultimately, this topic is expected to reduce the incidence of refractory rejection and infectious complications, thereby improving the clinical outcomes of liver cancer patients undergoing liver transplantation in the era of immune-based therapies.
This Research Topic accepts Original Research, Systematic Review, Methods, Review and Mini-Review, Clinical Trial, Perspective, Case Report, Brief Research Report. We welcome manuscripts focusing on, but not limited to, the following sub-topics:
• Opportunities and Challenges of Immunotherapy in Liver Transplantation for Hepatocellular Carcinoma
• Perioperative Immune System Remodeling During Liver Transplantation with Immunotherapy
• Bacterial, Fungal, Virus Infections in Liver Transplantation
• Infection Risk in Patients Experiencing Severe Rejection Following Liver Transplantation Under Immunotherapy
• Classification and Management of Post-Transplant Rejection in the Context of Immunotherapy
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