title: Acute renal allograft rejection after immune checkpoint inhibitor therapy for metastatic melanoma.
abstract: Immune checkpoint inhibitors such as ipilimumab and nivolumab improve survival in patients with advanced melanoma and are increasingly available to clinicians for use in the clinic. Their safety in organ transplant recipients is not well defined but published case reports describing treatment with ipilimumab have not been complicated by graft rejection. No cases of anti-programmed cell death protein 1 administration are reported in this group. We describe a case of acute graft rejection in a kidney transplant recipient after treatment with nivolumab, after progression on ipilimumab. Potential factors increasing the risk of graft rejection in this case are discussed, in particular the contribution of nivolumab.
authors.affiliation: Royal Marsden NHS Foundation Trust, London.
authors.forename: L
authors.initials: L
authors.lastname: Spain
authors.affiliation: University Hospitals Coventry and Warwickshire, Coventry.
authors.forename: R
authors.initials: R
authors.lastname: Higgins
authors.affiliation: University Hospitals Coventry and Warwickshire, Coventry.
authors.forename: K
authors.initials: K
authors.lastname: Gopalakrishnan
authors.affiliation: Royal Marsden NHS Foundation Trust, London; The Francis Crick Institute, Lincoln's Inn Fields Laboratory, London, UK.
authors.forename: S
authors.initials: S
authors.lastname: Turajlic
authors.affiliation: Royal Marsden NHS Foundation Trust, London.
authors.forename: M
authors.initials: M
authors.lastname: Gore
authors.affiliation: Royal Marsden NHS Foundation Trust, London. Electronic address: james.larkin@rmh.nhs.uk.
authors.forename: J
authors.initials: J
authors.lastname: Larkin
mesh_terms: D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000009:adverse effects; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage / Q000009:adverse effects; D060890:B7-H1 Antigen / Q000235:genetics / Q000276:immunology / Q000378:metabolism; D060908:CTLA-4 Antigen / Q000235:genetics / Q000276:immunology; D006084:Graft Rejection / Q000235:genetics / Q000276:immunology* / Q000473:pathology; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage* / Q000009:adverse effects; D007668:Kidney / Q000187:drug effects / Q000473:pathology; D008297:Male; D008545:Melanoma / Q000188:drug therapy* / Q000235:genetics / Q000276:immunology; D008875:Middle Aged; D009362:Neoplasm Metastasis; D000077594:Nivolumab; D061026:Programmed Cell Death 1 Receptor / Q000235:genetics / Q000276:immunology; D014184:Transplantation, Homologous; D059016:Tumor Microenvironment / Q000187:drug effects
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D060890:B7-H1 Antigen; C423236:CD274 protein, human; D060908:CTLA-4 Antigen; D007166:Immunosuppressive Agents; C105992:PDCD1 protein, human; D061026:Programmed Cell Death 1 Receptor; D000077594:Nivolumab; C582435:pembrolizumab
keywords: acute rejection; immune checkpoint inhibitor; kidney transplant; metastatic melanoma