*Purpose: Checkpoint inhibitor therapy is a hot and rapidly progressive therapy in advanced cancer patients in the past 2 years. Although some successful case report published about check-point therapy after organ transplantation, it is still contra-indicated to OLT patient because of the possibility of rejection.

*Methods: Until October 31st, 2019, 11 HCC patients receiving checkpoint inhibitor therapy for hepatocellular carcinoma recurrence or metastasis after liver transplantation (Table 1). 4 patients receive Pembrolizumab, 5 patients receive Nivolumab, 1 patient receives Pembrolizumab initially and switches to Nivolumab and another 1 patient is contrary. Besides, 3 patients receive target therapy, 2 patients receive dendritic cell therapy and 2 patients receive target therapy and dendritic therapy as well. The immunosuppression strategy for these patients is higher steroid dosage and lower CNI dosage.

*Results: Survival days are 1 month to 19 months and administration times are 1 to 21 times. 4 patients with partial responses are approved and 4 patients with progression are approved as well. There are 2 patients alive until now. Both of these 2 patients receive combined therapy of check-point inhibitor, target therapy, and dendritic therapy. Only 1 patient has approved liver graft rejection and dead of liver failure.

*Conclusions: Check-point inhibitor therapy could be a feasible and effective treatment in HCC recurrence or metastasis after LT, but we need more experiences to adjust immunosuppression. In our experiences, multidisciplinary treatment is better than single using of checkpoint inhibitor. It is similar to the results of clinical trials in advanced HCC.

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