Evidence map›Paper›PMID 41738362›Full record

ArticleClinical transplantation2026

Optimizing Liver Transplant Allocation for Hepatocellular Carcinoma: Development and Validation of a Survival Benefit-Based Model.

Hao Liu, Isabel Neckermann, Jason Mial-Anthony, Charbel Elias, Abiha Abdullah, Vrishketan Sethi, Christopher Kaltenmeier, Amaan Rahman, Eishan Ashwat, Packiaraj Godwin and 8 more

Abstract readValidation Study
In one paragraph

Article in Clinical transplantation, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors.

Hao LiuJ.C. Walter Jr. Transplant Center and Department of Surgery, Houston Methodist Hospital, Houston, Texas, USA.
Isabel NeckermannDepartment of Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.ORCID https://orcid.org/0000-0003-0152-9355
Jason Mial-AnthonyDepartment of Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
Charbel EliasDepartment of Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
Abiha AbdullahDepartment of Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
Vrishketan SethiDepartment of Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
Christopher KaltenmeierDepartment of Surgery, Georgetown University, Washington D.C., USA.
Amaan RahmanDepartment of Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
Eishan AshwatDepartment of Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
Packiaraj GodwinDepartment of Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
Subedi SabinDepartment of Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
Timothy FokkenDepartment of Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
Shwe HanDepartment of Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
Xingyu ZhangSchool of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Stalin DharmayanDepartment of Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
Jaideep BehariDepartment of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Stela CelajDepartment of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Michele MolinariDepartment of Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.ORCID https://orcid.org/0000-0002-9763-6253

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionLiver transplantation (LT) is the only curative option for patients with unrespectable hepatocellular carcinoma (HCC). In the United States. current organ allocation policies grant the same priority to patients with tumors within the Milan criteria. This uniform approach leads to higher waitlist dropout among candidated with more advanced tumors of with more aggressive tumor biology. A model to stratify HCC candidates into different risk groups could optimize organ allocation by providing priority to patients within transplantable criteria but at increased risk of dropout.

methodsData from 30,565 adult HCC LT candidates within the Scientific Registry of Transplant Recipients (SRTR) (2002-2022) were used. Inclusion criteria were age ≥18 years and tumors within Milan criteria. Recipients of previous transplants, multi-visceral grafts, and those with missing exception applications for HCC were excluded. The population was randomly divided into development (n = 15,282) and validation (n = 15,283) cohorts. The primary outcome was 5-year LT survival benefit, defined as the difference in survival with and without LT.

resultsC-MELD 3.0, serum AFP, and tumor burden score (TBS) were the strongest predictors of LT survival benefit. The HCC-Liver Transplant Survival Benefit model was defined as HCC-LTSB = 0.65 × (C-MELD 145 3.0 - 6) + 1.99 × (TBS - 2.25) + 0.68 × log2(AFP). Validation demonstrated strong performance (Pearson's r = 0.93; 95% CI: 0.93-0.94; R

conclusionThe HCC-LTSB model accurately predicted the survival benefit provided by LT in candidates listed with unresectable HCC within UNOS criteria.

Indexed as

Carcinoma, HepatocellularLiver NeoplasmsLiver TransplantationPatient SelectionResource AllocationTissue and Organ ProcurementWaiting ListsAdultFemaleFollow-Up StudiesHumansMaleMiddle AgedPrognosisRegistriesRisk Factorshepatocellular carcinomaliver transplantationmodel for end‐stage liver diseaseorgan allocationpredictive modeltransplant‐associated survival benefittumor burden scorewaitlist mortality

Identifiers

PMID41738362
PMCPMC12933510

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.