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During the congress, E-Posters will be accessible to all participants on the congress website 24/7, as well as in the E-poster stations in the congress center.
Preparing your E-Poster
Please review the E-Poster format requirements carefully when preparing your E-Poster. Should your E-Poster not meet the mentioned requirements, it may not be displayed as described above.
E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
Please follow the instructions below to input your abstract title.
Abstract titles should be brief and reflect the content of the abstract.
Solid organ transplant recipients (SOTRs) have increased cancer risk. In kidney transplant recipients (KTRs), cSCC and melanoma are common advanced malignancies. Immune checkpoint inhibitors (ICIs) can produce meaningful responses but carry a 30–40% risk of acute allograft rejection, often within weeks; mTORi with steroids may lower the risk. We report steroid-refractory ICI-associated renal rejection managed with low-dose local graft irradiation (LGI).
Single-patient case. A 57-year-old man with a 3-year living-donor renal graft developed biopsy-proven acute cellular rejection (Banff 1B) two months after starting dual ICI for metastatic melanoma. After pulse methylprednisolone with incomplete recovery, the renal allograft received localized low-dose radiotherapy (LD-RT): 4×50 cGy, then upon recurrence 4×100 cGy (3D-conformal; total ≈6 Gy). Immunosuppression was adjusted per our institutional protocol.
After the first LD-RT course, the creatinine improved from 1.7→1.4 mg/dL with symptomatic tolerance. Re-biopsy for recurrent dysfunction showed improved but persistent rejection (Banff 1A) with plasma-cell–rich infiltrate and fibrosis (15–20%). A second LD-RT course (4×100 cGy) again improved the creatinine to ~1.35 mg/dL without observed radiation toxicity. Literature synthesis: salvage-era LGI reports show functional recovery in a substantial subset but limited durability—Nuyttens (n=22; 150 cGy×3): CR 50%, PR 30%, 5-y graft survival ~34%; Wahl (n=33; median 800 cGy in 200 cGy×4): median dialysis-free survival 3.8 mo (1 mo 63%, 1 y 31%, 5 y 14%); Fallahzadeh (n=6; 150–200 cGy×4): improvement/stabilization 5/6, graft survival 83% (3 mo), 33% (6 mo), 17% (12 mo). Earlier studies using LGI as upfront adjunct showed no benefit.
LD-RT to the renal allograft was associated with biochemical and histologic improvement in this patient with ICI-associated, steroid-refractory rejection. The effect is biologically plausible: activated B/T lymphocytes are radiosensitive, whereas plasma cells/NK cells/monocytes-macrophages are comparatively resistant; renal parenchyma has higher injury thresholds (clinically relevant dysfunction typically at ≥18 Gy mean dose, while doses <15 Gy appear to carry minimal risk). When limiting systemic immunosuppression is crucial (active malignancy, serious infection, or contraindications), LGI may be considered after unsuccessful high-dose corticosteroids. Prospective studies should define dose–response and integration with modern immunosuppression strategies.
