You have accessJournal of UrologyRenal Transplantation & Vascular Surgery I (MP37)1 Sep 2021MP37-11 USE OF IMMUNE CHECKPOINT INHIBITORS IN SOLID ORGAN TRANSPLANT RECIPIENTS: A SCOPING REVIEW Alexander Anderson, Miranda Eubank, Diane Johnson, and Katie Murray Alexander AndersonAlexander Anderson More articles by this author , Miranda EubankMiranda Eubank More articles by this author , Diane JohnsonDiane Johnson More articles by this author , and Katie MurrayKatie Murray More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002046.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Immune checkpoint inhibitors (ICI) are an emerging treatment for numerous advanced diseases, but their safety and efficacy in immunosuppressed transplant patients is not known. This study undertakes a scoping review of research on ICI use in solid organ transplant (SOT) recipients to determine: 1) What is the effect of ICI on SOT recipients?; 2) What factors influence the effect of ICI on SOT recipients? METHODS: Data Sources: Searches of PubMed, Scopus and MEDLINE were performed with language restrictions on September 1, 2020. Study Selection: Any studies that reported the use of ICI in patients with a history of SOT were included irrespective of study design. Data Extraction: Three reviewers independently screened citations and performed data abstractions. A variety of variables were extracted from each publication. Data Synthesis: Of the total 549 screened articles, 50 articles met inclusion criteria with a sum of 101 cases of ICI use in patients with a history of SOT. RESULTS: Graft rejection occurred in 42% (n=42) of the cases. Kidneys were the most commonly rejected organ (n=28) with PD-1 inhibitors being the often-implicated etiology (n=32). Nearly 100% of the cases of graft rejection transpired within 2 months of ICI initiation. Patients on steroid monotherapy had higher rejection rates (72%, n=13) versus those on a steroid plus one or more immunosuppressive agents. In cases where graft preservation was pursued, salvage occurred 33% of the time (n=9). Regardless of graft outcomes, patient outcomes were overall poor due to advanced disease. In cases where patient outcome was reported, 71% (n=39) died directly from disease progression. CONCLUSIONS: ICI offer a promising therapeutic alternative to traditional chemoradiation for patients with advanced malignancies. However, their use in patients with a history of SOT poses a significant risk to the transplanted organ and cancer outcomes are worse in patients with SOT. Future studies are needed to delineate the risk and benefit more clearly. . . Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e650-e650 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Alexander Anderson More articles by this author Miranda Eubank More articles by this author Diane Johnson More articles by this author Katie Murray More articles by this author Expand All Advertisement Loading ...