Management of hepatocellular carcinoma prior to liver transplantation: latest developments

Hepatocellular carcinoma (HCC) is a highly morbid malignancy that is a leading cause of death in patients with cirrhosis or chronic hepatitis B. Liver transplantation is considered a curative therapy for HCC, with 5-year survival rates exceeding 75%. Current allocation policy in the US restricts tra...

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Main Authors: Antoine Robert, Thomas M. Hunold, Neehar D. Parikh
Format: Article
Language:English
Published: Taylor & Francis 2025-12-01
Series:Hepatic Oncology
Subjects:
Online Access:https://www.tandfonline.com/doi/10.1080/20450923.2025.2549676
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author Antoine Robert
Thomas M. Hunold
Neehar D. Parikh
author_facet Antoine Robert
Thomas M. Hunold
Neehar D. Parikh
author_sort Antoine Robert
collection DOAJ
description Hepatocellular carcinoma (HCC) is a highly morbid malignancy that is a leading cause of death in patients with cirrhosis or chronic hepatitis B. Liver transplantation is considered a curative therapy for HCC, with 5-year survival rates exceeding 75%. Current allocation policy in the US restricts transplant to patients with early HCC, and priority for transplant is granted after 6 months on the waitlist, thus patients often require therapies for cancer control while awaiting liver transplantation. The most commonly applied therapies for HCC in patients awaiting liver transplantation are locoregional therapies, including ablative, radiation, and arterial based therapies. Using these therapies patient can be effectively bridged or downstaged to liver transplantation, however there are risks of progressive liver decompensation with locoregional therapies in patients with portal hypertension. There are emerging data for the use of immune checkpoint inhibitor-based immunotherapies in the treatment of HCC. While there has been concern for rejection with the administration of immunotherapy prior to liver transplantation, early data suggest that the risk can be minimized with sufficient washout time prior to liver transplantation. Herein we aim to review management strategies for patients with HCC awaiting liver transplantation.
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spelling doaj-art-3dcba8eee1d34645b6ac6074c9b417792025-08-23T13:09:52ZengTaylor & FrancisHepatic Oncology2045-09232045-09312025-12-0112110.1080/20450923.2025.2549676Management of hepatocellular carcinoma prior to liver transplantation: latest developmentsAntoine Robert0Thomas M. Hunold1Neehar D. Parikh2Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, MI, USADivision of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, MI, USADivision of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, MI, USAHepatocellular carcinoma (HCC) is a highly morbid malignancy that is a leading cause of death in patients with cirrhosis or chronic hepatitis B. Liver transplantation is considered a curative therapy for HCC, with 5-year survival rates exceeding 75%. Current allocation policy in the US restricts transplant to patients with early HCC, and priority for transplant is granted after 6 months on the waitlist, thus patients often require therapies for cancer control while awaiting liver transplantation. The most commonly applied therapies for HCC in patients awaiting liver transplantation are locoregional therapies, including ablative, radiation, and arterial based therapies. Using these therapies patient can be effectively bridged or downstaged to liver transplantation, however there are risks of progressive liver decompensation with locoregional therapies in patients with portal hypertension. There are emerging data for the use of immune checkpoint inhibitor-based immunotherapies in the treatment of HCC. While there has been concern for rejection with the administration of immunotherapy prior to liver transplantation, early data suggest that the risk can be minimized with sufficient washout time prior to liver transplantation. Herein we aim to review management strategies for patients with HCC awaiting liver transplantation.https://www.tandfonline.com/doi/10.1080/20450923.2025.2549676Hepatocellular carcinomaliver transplantationdownstagemilantransarterial chemoembolizationtransarterial radioembolization
spellingShingle Antoine Robert
Thomas M. Hunold
Neehar D. Parikh
Management of hepatocellular carcinoma prior to liver transplantation: latest developments
Hepatic Oncology
Hepatocellular carcinoma
liver transplantation
downstage
milan
transarterial chemoembolization
transarterial radioembolization
title Management of hepatocellular carcinoma prior to liver transplantation: latest developments
title_full Management of hepatocellular carcinoma prior to liver transplantation: latest developments
title_fullStr Management of hepatocellular carcinoma prior to liver transplantation: latest developments
title_full_unstemmed Management of hepatocellular carcinoma prior to liver transplantation: latest developments
title_short Management of hepatocellular carcinoma prior to liver transplantation: latest developments
title_sort management of hepatocellular carcinoma prior to liver transplantation latest developments
topic Hepatocellular carcinoma
liver transplantation
downstage
milan
transarterial chemoembolization
transarterial radioembolization
url https://www.tandfonline.com/doi/10.1080/20450923.2025.2549676
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AT thomasmhunold managementofhepatocellularcarcinomapriortolivertransplantationlatestdevelopments
AT neehardparikh managementofhepatocellularcarcinomapriortolivertransplantationlatestdevelopments