Article
Surgery
Hannah Kaminski, Nassim Kamar, Olivier Thaunat, Nicolas Bouvier, Sophie Caillard, Isabelle Garrigue, Dany Anglicheau, Jean-Philippe Rerolle, Yannick Le Meur, Antoine Durrbach, Thomas Bachelet, Helene Savel, Roxane Coueron, Jonathan Visentin, Arnaud Del Bello, Isabelle Pellegrin, Julie Dechanet-Merville, Pierre Merville, Rodolphe Thiebaut, Lionel Couzi
Summary: This study found that everolimus can decrease the incidence of CMV DNAemia and disease in CMV seropositive solid organ transplant recipients.
AMERICAN JOURNAL OF TRANSPLANTATION
(2022)
Article
Gastroenterology & Hepatology
Midas B. Mulder, Bart van Hoek, Aad P. van den Berg, Wojciech G. Polak, Ian P. J. Alwayn, Koert P. de Jong, Brenda C. M. de Winter, Elke Verhey-Hart, Nicole S. Erler, Caroline M. den Hoed, Herold J. Metselaar
Summary: The aim of this study was to compare the effects of low-dose sirolimus and low-dose extended-release tacrolimus with normal-dose extended-release tacrolimus on renal function and rejection, graft and patient survival rates at 36 months after transplantation. This was an open-label, multicenter randomized controlled trial. The study found that there was no significant difference in the incidence of chronic kidney disease at 36 months between the groups, but in the intention-to-treat population, the interventional group had higher estimated glomerular filtration rate at 6 months.
LIVER TRANSPLANTATION
(2023)
Article
Oncology
Mary F. Mulcahy, Armeen Mahvash, Marc Pracht, Amir H. Montazeri, Steve Bandula, Robert C. G. Martin, Ken Herrmann, Ewan Brown, Darryl Zuckerman, Gregory Wilson, Tae-You Kim, Andrew Weaver, Paul Ross, William P. Harris, Janet Graham, Jamie Mills, Alfonso Yubero Esteban, Matthew S. Johnson, Constantinos T. Sofocleous, Siddharth A. Padia, Robert J. Lewandowski, Etienne Garin, Philip Sinclair, Riad Salem
Summary: The study demonstrates that the addition of TARE to second-line chemotherapy for CLM patients results in longer progression-free survival and hepatic progression-free survival, with an improved objective response rate. However, there was no significant difference in overall survival between the two groups, and the rate of grade 3 adverse events was higher in the TARE group. Further subset analyses are needed to identify the ideal patient population for TARE benefit.
JOURNAL OF CLINICAL ONCOLOGY
(2021)
Article
Surgery
Yoshitsugu Obi, Naotsugu Ichimaru, Yusuke Sakaguchi, Kazuhiro Iwadoh, Daisuke Ishii, Ken Sakai, Daiki Iwami, Hiroshi Harada, Keiichi Sumida, Akinari Sekine, Kosuke Masutani, Naotake Akutsu, Takamitsu Inoue, Morikuni Nishihira, Tatsuo Yoneda, Shinichi Ito, Motoo Araki, Jun-Ya Kaimori, Katsunori Yoshida, Shigeru Satoh, Yoshifumi Ubara, Yoshitaka Isaka, Kazunari Yoshida, Yoshiharu Tsubakihara, Shiro Takahara, Takayuki Hamano
Summary: The study findings suggest that aggressive correction of anemia may help preserve allograft kidney function, while vitamin D supplementation did not significantly impact eGFR.
TRANSPLANT INTERNATIONAL
(2021)
Article
Surgery
Matteo Serenari, Jacopo Lenzi, Alessandro Cucchetti, Federica Cipriani, Matteo Donadon, Francesco Ardito, Federico Fazio, Daniele Nicolini, Maurizio Iaria, Simone Famularo, Pasquale Perri, Luca Ansaloni, Matteo Zanello, Quirino Lai, Simone Conci, Sarah Molfino, Cecilia Ferrari, Paola Germani, Mauro Zago, Maurizio Romano, Giuseppe Zimmitti, Adelmo Antonucci, Luca Fumagalli, Albert Troci, Valentina Ferraro, Riccardo Memeo, Michele Crespi, Marco Chiarelli, Giorgio A. Ercolani, Mohamed A. Hilal, Giacomo Zanus, Enrico Pinotti, Paola Tarchi, Guido Griseri, Gian Luca Baiocchi, Andrea Ruzzenente, Massimo Rossi, Elio Jovine, Marcello Maestri, Gian Luca Grazi, Fabrizio Romano, Raffaele Dalla Valle, Matteo Ravaioli, Marco Vivarelli, Alessandro Ferrero, Felice Giuliante, Guido Torzilli, Luca Aldrighetti, Matteo Cescon
Summary: This study aimed to evaluate the impact of a liver transplantation program on the outcomes of resectable hepatocellular carcinoma. The presence of a liver transplantation program was associated with decreased posthepatectomy liver failure rates and increased likelihood of salvage liver transplantation in case of tumor recurrence, which had a positive impact on postoperative survival.
Article
Oncology
Qianwei Ye, Sunbin Ling, Guangjiang Jiang, Qiaonan Shan, Shengjun Xu, Qifan Zhan, Yifeng Wu, Yuchen Liu, Shusen Zheng, Xiao Xu
Summary: The use of SRL-based immunosuppression in liver transplant recipients with HCC beyond the Milan criteria showed improved prognosis, especially in patients with lower TSC1 or TSC2 expression levels. TSC1 knockdown promoted HCC malignancy and enhanced sensitivity to SRL.
Article
Gastroenterology & Hepatology
Ren-Yi Su, Sun-Bin Ling, Qiao-Nan Shan, Xu-Yong Wei, Rui Wang, Chang-Ku Jia, Li Zhuang, Tian Shen, Li-Min Ding, Zhi-Dan Xu, Lai-Bang Luo, Li-Bo Sun, Guang-Ming Li, Tai-Shi Fang, Nan Jiang, Kun Zhang, Zhao-Jie Su, Zhi-Hai Peng, Ren Lang, Tao Jiang, Qiang He, Lin-Sen Ye, Yang Yang, Yu-Ting He, Wen-Zhi Guo, Liu-Gen Lan, Xu-Yong Sun, Dong Chen, Zhi-Shui Chen, Da-Wei Zhou, Shao-Jun Ye, Qi-Fa Ye, Min Tian, Jian-Hua Shi, Bo Wang, Jiang Liu, Qian Lu, Wei Rao, Jin-Zhen Cai, Tao Lv, Jia-Yin Yang, Pu-Sen Wang, Lin Zhong, Jing-Sheng Ma, Qi-Gen Li, Sheng-Dong Wu, Chang-Jiang Lu, Cai-De Lu, Dong-Hua Zhang, Xuan Wang, Zi-Qiang Li, Mu-Jian Teng, Jun-Jie Li, Wen-Tao Jiang, Jian-Hua Li, Quan-Bao Zhang, Ning-Qi Zhu, Zheng-Xin Wang, Kang He, Qiang Xia, Shao-Hua Song, Zhi-Ren Fu, Wei Qiu, Guo-Yue Lv, Rui-Peng Song, Ji-Zhou Wang, Zheng Wang, Jian Zhou, Gang Chen, Ying-Peng Zhao, Li Li, Ze-Min Hu, Qi-Jie Luo, Zhong-Zhou Si, Bin Xie, Xiao-Shun He, Zhi-Yong Guo, Shu-Sen Zheng, Xiao Xu
Summary: Mammalian target of rapamycin (mTOR) inhibitor has been extensively studied in Western countries, particularly in liver transplant recipients. However, there is a lack of similar studies in Eastern countries. Therefore, we designed a clinical trial to investigate the efficacy of sirolimus in hepatocellular carcinoma (HCC) patients after liver transplantation.
HEPATOBILIARY & PANCREATIC DISEASES INTERNATIONAL
(2022)
Article
Pharmacology & Pharmacy
Mosaburo Kainuma, Shinji Ouma, Shinobu Kawakatsu, Osamu Iritani, Ken-Ichiro Yamashita, Tomoyuki Ohara, Shigeki Hirano, Shiro Suda, Tadanori Hamano, Sotaro Hieda, Masaaki Yasui, Aoi Yoshiiwa, Seiji Shiota, Masaya Hironishi, Kenji Wada-Isoe, Daiki Sasabayashi, Sho Yamasaki, Masayuki Murata, Kouta Funakoshi, Kouji Hayashi, Norimichi Shirafuji, Hirohito Sasaki, Yoshinori Kajimoto, Yukiko Mori, Michio Suzuki, Hidefumi Ito, Kenjiro Ono, Yoshio Tsuboi
Summary: This study evaluated the effectiveness of hachimijiogan in the treatment of mild Alzheimer's disease. The results showed that hachimijiogan had an adjuvant effect and delayed the deterioration of cognitive dysfunction in patients.
FRONTIERS IN PHARMACOLOGY
(2022)
Article
Chemistry, Medicinal
Koen G. A. M. Hussaarts, Leni van Doorn, Sander Bins, Dave Sprengers, Peter de Bruijn, Roelof W. F. van Leeuwen, Stijn L. W. Koolen, Teun van Gelder, Ron H. J. Mathijssen
Summary: The study found that sorafenib exposure decreased over time during combined treatment with immunosuppressants, and two patients also experienced declining tacrolimus plasma levels. Patients were unable to increase the sorafenib dose higher than 200 mg b.i.d. without experiencing significant toxicity.
Article
Gastroenterology & Hepatology
Peng Liu, Xin Wang, Huan Liu, Shu-Xian Wang, Qing-Guo Xu, Lin Wang, Xiao Xu, Jin-Zhen Cai
Summary: This study aimed to evaluate the prognosis of liver transplantation patients with hepatocellular carcinoma (HCC) in the setting of cirrhosis. The results showed that the use of sirolimus significantly improved the recurrence-free survival and overall survival compared to non-sirolimus group.
HEPATOBILIARY & PANCREATIC DISEASES INTERNATIONAL
(2023)
Article
Oncology
Zhenggang Ren, Michel Ducreux, Ghassan K. Abou-Alfa, Philippe Merle, Weijia Fang, Julien Edeline, Zhiwei Li, Lihua Wu, Eric Assenat, Sheng Hu, Lorenza Rimassa, Tao Zhang, Jean-Frederic Blanc, Hongming Pan, Paul Ross, Chia-Jui Yen, Albert Tran, Guoliang Shao, Mohamed Bouattour, Yajin Chen, Tim Meyer, Jinlin Hou, David Tougeron, Yuxian Bai, Ming-Mo Hou, Zhiqiang Meng, John Wu, Vincent Li, Sandra Chica-Duque, Ann-Lii Cheng
Summary: Tislelizumab demonstrated durable antitumor activity and acceptable tolerability in previously treated advanced HCC patients, regardless of the number of prior lines of therapy.
Article
Immunology
Midas B. Mulder, Jan van Busschbach, Bart van Hoek, Aad P. van den Berg, Wojtek G. Polak, Ian P. J. Alwayn, Brenda de C. M. de Winter, Elke Verhey-Hart, Nicole S. Erler, Caroline M. den Hoed, Herold J. Metselaar
Summary: This study investigated the impact of different immunosuppression regimes on the health-related quality of life (HRQoL) and severity of fatigue in liver transplant recipients. The results showed that after 36 months post-transplantation, the HRQoL and fatigue severity were similar in both study groups, and the HRQoL of all patients was comparable to that of the general population.
Article
Medicine, General & Internal
Stefano Gitto, Lucia Golfieri, Filippo Gabrielli, Margherita Falcini, Francesco Sofi, Maria Rosa Tame, Nicola De Maria, Luca Marzi, Andrea Mega, Giovanna Valente, Alberto Borghi, Paolo Forte, Matteo Cescon, Fabrizio Di Benedetto, Pietro Andreone, Marco Petranelli, Maria Cristina Morelli, Paolo De Simone, Chloe Lau, Laura Stefani, Francesco Vizzutti, Francesca Chiesi, Fabio Marra
Summary: A significant proportion of liver transplant recipients have insufficient levels of physical activity or are completely inactive, and this inactivity is associated with the time since transplant, suboptimal diet, and low quality of life.
INTERNAL AND EMERGENCY MEDICINE
(2023)
Article
Oncology
Leifeng Liang, Zhibing Liu, Haisheng Zhu, Hongqian Wang, Yan Wei, Xuejian Ning, Zhiling Shi, Liujun Jiang, Zhan Lin, Haolin Yan, Rensheng Wang, Kai Hu
Summary: This multicenter clinical trial found that thalidomide could prolong the latency period of oral mucositis, reduce its incidence, and have no impact on the short-term efficacy of concurrent chemoradiotherapy in patients with nasopharyngeal carcinoma.
Article
Gastroenterology & Hepatology
Shi-Ye Yang, Jin-Kai Feng, Mao-Lin Yan, Lei Guo, Yun-Fei Duan, Jia-Zhou Ye, Zong-Han Liu, Yan-Jun Xiang, Li Xu, Jie Xue, Jie Shi, Wan Yee Lau, Shu-Qun Cheng, Wei-Xing Guo
Summary: This study aimed to compare the perioperative results and long-term oncological outcomes of HCC patients with T2DM treated with LLR versus OLR. The LLR group had less blood loss, shorter hospitalization, and fewer postoperative complications compared to the OLR group. LLR showed significantly better overall survival and recurrence-free survival for HCC patients with T2DM regardless of the course of T2DM.
HEPATOLOGY INTERNATIONAL
(2023)
Article
Gastroenterology & Hepatology
Carla Montironi, Florian Castet, Philipp K. Haber, Roser Pinyol, Miguel Torres-Martin, Laura Torrens Fontanals, Agavni Mesropian, Huan Wang, Marc Puigvehi, Miho Maeda, Wei Qiang Leow, Elizabeth Harrod, Patricia Taik, Jigjidsuren Chinburen, Erdenebileg Taivanbaatar, Enkhbold Chinbold, Manel Sole Arques, Michael Donovan, Swan Thung, Jaclyn Neely, Vincenzo Mazzaferro, Jeffrey Anderson, Sasan Roayaie, Myron Schwartz, Augusto Villanueva, Scott L. Friedman, Andrew Uzilov, Daniela Sia, Josep M. Llovet
Summary: This study characterizes the immunogenomic contexture of hepatocellular carcinoma (HCC) and defines inflamed and non-inflamed tumors. Two distinct patterns of CTNNB1 are associated with differential immune evasion and may help predict immune response in HCC.
Letter
Gastroenterology & Hepatology
Alberto Zanetto, Elena Campello, Cristiana Bulato, Patrizia Burra, Marco Senzolo, Paolo Simioni
DIGESTIVE AND LIVER DISEASE
(2023)
Article
Medicine, General & Internal
Quirino Lai, Nicoletta De Matthaeis, Michele Finotti, Giovanni Galati, Giuseppe Marrone, Fabio Melandro, Filomena Morisco, Daniele Nicolini, Riccardo Pravisani, Edoardo G. Giannini
Summary: This study evaluates the impact of antiplatelet therapy on the incidence and mortality of hepatocellular carcinoma. The results suggest that antiplatelet therapy is associated with a reduced risk of HCC incidence and post-treatment mortality.
EUROPEAN JOURNAL OF CLINICAL INVESTIGATION
(2023)
Article
Gastroenterology & Hepatology
Giada Aizza, Nadia Russolillo, Alessandro Ferrero, Nicholas L. Syn, Federica Cipriani, Davit Aghayan, Marco Marino, Riccardo Memeo, Vincenzo Mazzaferro, Adrian K. H. Chiow, Iswanto Sucandy, Arpad Ivanecz, Marco Vivarelli, Fabrizio Di Benedetto, Sung-Hoon Choi, Jae Hoon Lee, James O. Park, Mikel Gastaca, Constantino Fondevila, Mikhail Efanov, Fernando Rotellar, Gi-Hong Choi, Ricardo Robles-Campos, Xiaoying Wang, Robert P. Sutcliffe, Johann Pratschke, Chung Ngai Tang, Charing C. Chong, Mathieu D'Hondt, Chee Chien Yong, Andrea Ruzzenente, Paolo Herman, T. Peter Kingham, Olivier Scatton, Rong Liu, Giovanni Battista Levi Sandri, Olivier Soubrane, Alejandro Mejia, Santiago Lopez-Ben, Kazateru Monden, Go Wakabayashi, Daniel Cherqui, Roberto Troisi, Mengqiu Yin, Felice Giuliante, David Geller, Atsushi Sugioka, Bjorn Edwin, Tan-To Cheung, Tran Cong Duy Long, Mohammad Abu Hilal, David Fuks, Kuo-Hsin Chen, Luca Aldrighetti, Ho-Seong Han, Brian K. P. Goh
Summary: This study aimed to investigate the relationship between tumor size and the difficulty of laparoscopic left lateral sectionectomy (L-LLS). Three optimal tumor size cutoffs (40-, 70-, and 100-mm) were identified. As tumor size increased, there was a stepwise increase in the rates of open conversion, operative time, blood loss, intraoperative blood transfusion, Pringle maneuver use, major morbidity, and 30-day readmission.
JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES
(2023)
Editorial Material
Gastroenterology & Hepatology
Bart van Hoek
JOURNAL OF CLINICAL AND TRANSLATIONAL HEPATOLOGY
(2023)
Correction
Surgery
Matteo Serenari, Francesca Ratti, Nicola Guglielmo, Matteo Zanello, Federico Mocchegiani, Jacopo Lenzi, Michele Colledan, Vincenzo Mazzaferro, Umberto Cillo, Alessandro Ferrero, Matteo Cescon, Fabrizio Di Benedetto, Marco Massani, Gianluca Grazi, Raffaele Dalla Valle, Marco Vivarelli, Giuseppe Maria Ettorre, Luca Aldrighetti, Elio Jovine, Stefania Camagni, Fabio Forchino, Enrico Gringeri, Salvatore Gruttadauria, Paolo Magistri, Bruno Nardo, Matteo Ravaioli, Fabrizio Romano, Maurizio Romano, Andrea Scarinci, Matteo Virdis, Giacomo Zanus
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES
(2023)
Review
Virology
Sara Battistella, Alberto Zanetto, Martina Gambato, Giacomo Germani, Marco Senzolo, Patrizia Burra, Francesco Paolo Russo
Summary: Hepatitis B virus (HBV) is a prevalent disease leading to liver transplantation (LT) for cirrhosis and hepatocellular carcinoma (HCC) patients. The presence of hepatitis delta virus (HDV) accelerates liver injury and HCC progression in HBsAg carriers. Post-transplantation, combination therapy with HBIG and NUCs has improved patient survival by preventing re-infection and recurrence. High-barrier NUCs like entecavir and tenofovir are safe and effective for low-risk HBV reactivation. Last-generation NUCs allow for the use of anti-HBc and HBsAg-positive grafts due to organ shortage.
Article
Gastroenterology & Hepatology
Felice Giuliante, Francesca Ratti, Elena Panettieri, Vincenzo Mazzaferro, Alfredo Guglielmi, Giuseppe M. Ettorre, Salvatore Gruttadauria, Fabrizio Di Benedetto, Umberto Cillo, Luciano De Carlis, Raffaele Dalla Valle, Alessandro Ferrero, Roberto Santambrogio, Francesco Ardito, Luca Aldrighetti
Summary: The use of minimally invasive liver surgery has greatly reduced surgical risk for hepatocellular carcinoma. This study analyzed the outcomes of minimally invasive liver surgery for small hepatocellular carcinoma tumors less than 3 cm in size.
Review
Gastroenterology & Hepatology
Debora Bizzaro, Chiara Becchetti, Silvia Trapani, Bruna Lavezzo, Alberto Zanetto, Francesca D'Arcangelo, Manuela Merli, Lucia Lapenna, Federica Invernizzi, Gloria Taliani, Patrizia Burra
Summary: Alcohol-related liver disease (ArLD) is a leading cause of chronic liver disease worldwide. The sex gap in ArLD is narrowing due to increasing alcohol consumption among women, who are more vulnerable to its harmful effects. Women have a higher risk of cirrhosis and liver-related mortality compared to men. This review summarizes the current knowledge on sex differences in alcohol metabolism, ArLD pathogenesis, disease progression, liver transplant indications, and pharmacological treatments, emphasizing the importance of a sex-specific management approach.
UNITED EUROPEAN GASTROENTEROLOGY JOURNAL
(2023)
Article
Surgery
Frederik J. H. Hoogwater, Hendrien Kuipers, Vincent E. de Meijer, Charlotte Maulat, Fabrice Muscari, Wojciech G. Polak, Bart van Hoek, Caroline Jezequel, Ian P. J. Alwayn, Jan N. M. Ijzermans, Kayvan Mohkam, Jean-Yves Mabrut, Frederike G. Van Vilsteren, Jean-Philippe Adam, Laurence Chiche, Alexandre Chebaro, Emmanuel Boleslawski, Jeroen Dubbeld, Sarwa Darwish Murad, Michel Rayar, Robert J. Porte
Summary: This study compared outcomes after liver transplantation for perihilar cholangiocarcinoma using strict selection criteria, with or without neoadjuvant chemoradiotherapy. The results showed that patients who received neoadjuvant chemoradiotherapy had lower post-transplant survival rates but lower tumor recurrence rates. Adjustments in neoadjuvant chemoradiotherapy may improve outcomes in these patients. Rating: 7 out of 10.
Article
Nutrition & Dietetics
Daphne Bot, Claudia Lucassen, Maarten Werkman, Sylvia van Dijk, Shirin Shahbazi Feshtali, Maarten E. Tushuizen, Bart van Hoek
Summary: The main purpose of this study was to investigate the association between low skeletal muscle index (SMI) and myosteatosis with physical fitness in patients with end-stage liver disease (ESLD). The results showed that myosteatosis was significantly associated with decreased cardiorespiratory fitness (CRF), while SMI had no significant association with physical fitness. Therefore, physical exercise training may be particularly beneficial for LT candidates with myosteatosis.
CLINICAL NUTRITION ESPEN
(2023)
Article
Gastroenterology & Hepatology
Federico Pinero, Charlotte Costentin, Helena Degroote, Andrea Notarpaolo, Ilka FSF. Boin, Karim Boudjema, Cinzia Baccaro, Aline Chagas, Philippe Bachellier, Giuseppe Maria Ettorre, Jaime Poniachik, Fabrice Muscari, Fabrizio Dibenedetto, Sergio Hoyos Duque, Ephrem Salame, Umberto Cillo, Sebastian Marciano, Claire Vanlemmens, Stefano Fagiuoli, Flair Carrilho, Daniel Cherqui, Patrizia Burra, Hans Van Vlierberghe, Quirino Lai, Marcelo Silva, Fernando Rubinstein, Christophe Duvoux
Summary: This study compared the predictive performance of two composite models (AFP score and Metroticket 2.0) for post-liver transplantation recurrence in hepatocellular carcinoma patients, and evaluated the net risk reclassification based on each model's original thresholds. The results showed that both models demonstrated similar ability to predict HCC recurrence after liver transplantation, and the combination of these models might be a promising clinical approach.
Article
Gastroenterology & Hepatology
Simone Incicco, Marta Tonon, Nicola Zeni, Carmine Gambino, Roberta Gagliardi, Valeria Calvino, Anna Barone, Gianluca Zilio, Paolo Feltracco, Patrizia Burra, Umberto Cillo, Paolo Angeli, Salvatore Piano
Summary: Bacterial infections in patients with cirrhosis increase the risk of complications and death after liver transplantation. However, despite the risk, post-transplant survival rates are excellent, indicating that transplant should not be delayed due to concerns about pre-transplant infections.
Article
Virology
Martina Gambato, Chiara Manuli, Erica N. Lynch, Sara Battistella, Giacomo Germani, Marco Senzolo, Alberto Zanetto, Alberto Ferrarese, Alessandro Vitale, Enrico Gringeri, Umberto Cillo, Patrizia Burra, Francesco Paolo Russo
Summary: This study investigated the long-term impact of sustained virological response (SVR) on fibrosis progression and patient survival in liver transplantation (LT) recipients treated with direct-acting antivirals (DAAs). The results showed that SVR12 was associated with improvement in hepatic function, liver fibrosis, and post-LT survival, regardless of the baseline fibrosis level. Presence of portal hypertension before DAAs had an impact on patient survival even after SVR12.
Article
Gastroenterology & Hepatology
Ben F. J. Goudsmit, Ilaria Prosepe, Maarten E. Tushuizen, Vincenzo Mazzaferro, Ian P. J. Alwayn, Bart van Hoek, Andries E. Braat, Hein Putter
Summary: In this study, the bias-corrected LT survival benefit for patients with(out) HCC who underwent a transplant was calculated using longitudinal data. The results showed that performing a transplant in patients with HCC resulted in individual survival benefit, but on a population level, patients without HCC gained more survival benefit from transplantation.