Surgery · Oncology · 2 h ago
Machine perfusion linked to lower HCC recurrence beyond Milan criteria
A UNOS database study of 19,466 adults who received liver transplants for hepatocellular carcinoma (HCC) examined post-transplant recurrence and survival with machine perfusion. In a propensity-matched subgroup beyond Milan criteria, machine perfusion was associated with lower recurrence at one and three years, but not with improved overall survival.
- UNOS cohort included 19,466 liver transplant recipients with HCC.
- MP was used in 7.2% of transplants.
- Beyond Milan criteria, MP was associated with lower recurrence.
- No significant overall-survival difference was observed.
Researchers analyzed United Network for Organ Sharing database records for adults with HCC who underwent liver transplantation from 2015 to 2025. They compared post-transplant HCC recurrence and overall survival in recipients whose donor livers underwent machine perfusion (MP) and those whose organs did not. The study included 19,466 patients; MP was used in 1,392 (7.2%). After propensity score matching, 512 patients were included in each group. The analysis also examined outcomes by whether patients were within or beyond the Milan criteria.
Among matched patients beyond Milan criteria (n=352), MP use was associated with lower risks of HCC recurrence at one year (adjusted hazard ratio [aHR] 0.09; p=0.02) and three years (aHR 0.27; p=0.02). There was no statistically significant association with overall survival at either time point: aHR 1.34 at one year (p=0.64) and 1.32 at three years (p=0.54). The abstract did not report a recurrence benefit in the within-Milan subgroup.
These observational findings suggest a possible association between MP and reduced recurrence in recipients beyond Milan criteria, but do not establish causation or show an overall-survival benefit. The authors call for validation in larger cohorts as MP use increases.
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Annals of Surgical Oncology: Impact of Machine Perfusion on Liver Transplantation for Hepatocellular Carcinoma ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.