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This study compares living-donor liver transplantation (LDLT) and machine perfusion (MP) using national data. Methodology: Between January 1, 2017 and December 31, 2023, 935 HCC patients underwent liver transplantation with either MP or LDLT. Results: MP recipients were older, obese, and more likely diabetic, with worse function status but a shorter length of stay (9.6 vs. 15.8 days), similar graft failure (3.1% vs. 3.6%), and comparable rehospitalization in follow-up data. Conclusions: Shifting organ allocation reduced HCC transplant rates; LDLT expands access, while MP may broaden options for less ideal living donor candidates.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/characterization-of-current-utilization-of-machine-perfusion-and-living-donor-liver-transplantation-for-hepatocellular-carcinoma/418589/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/characterization-of-current-utilization-of-machine-perfusion-and-living-donor-liver-transplantation-for-hepatocellular-carcinoma/418589.png","ImageObject",300,407,{"name":92,"@type":93},"Damian","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-28",true,{"@type":102,"interactionType":103,"userInteractionCount":44},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What comparison does the study make between liver transplantation approaches?","Question",{"text":112,"@type":113},"The study compares living-donor liver transplantation (LDLT) with machine perfusion (MP) for patients with hepatocellular carcinoma (HCC).","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How did patient characteristics differ between MP and LDLT groups?",{"text":117,"@type":113},"Patients receiving MP were more likely to be older, obese, and diabetic, and they had lower function status compared with those receiving LDLT.",{"name":119,"@type":110,"acceptedAnswer":120},"What outcomes were similar and what outcomes differed between MP and LDLT?",{"text":121,"@type":113},"MP was associated with a significantly shorter length of stay than LDLT, while graft failure rates were comparable and rehospitalization rates were similar in available follow-up data.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},418589,1790908703,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":44,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":52,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":144,"preview_page_count":4},137451208677,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d","Received 09/22/2025  \nReview began 11/02/2025  \nReview ended 11/24/2025  \nPublished 12/03/2025  \n© Copyright 2025  \nTaute et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0. , which permits unrestricted use , distribution , and reproduction in any medium , provided the original author and source are credited.  \nDOI: 10.7759/cureus.98365  \nOpen Access Original Article  \n Published via ACOS General Surgery  \nCharacterization of Current Utilization of Machine Perfusion and Living-Donor Liver Transplantation for Hepatocellular Carcinoma  \nElana Taute 1 , Nina L. Eng 1, Sean P. Martin 1  \n1. Department of Surgery, Penn State Health Milton S. Hershey Medical Center, Hershey, USA Corresponding author: Sean P. Martin, [smartin9@pennstatehealth.psu.edu](smartin9@pennstatehealth.psu.edu)  \nAbstract  \nBackground: Patients diagnosed with hepatocellular carcinoma (HCC) have experienced a decreased rate of deceased-donor transplants. We aimed to examine differences between two alternative approaches: livingdonor liver transplantation (LDLT) and machine perfusion (MP) .  \nMethodology: Using national data, we identified 935 patients who underwent liver transplantation for a primary diagnosis of HCC between January 1, 2017, and December 31, 2023, using either MP or LDLT.  \nResults: A total of 537 patients were transplanted using MP compared with 398 with LDLT. Throughout the study period, patients transplanted using MP were more likely to be older (odds ratio (OR) 1.03, P \u003C 0 .01), obese (OR 1.53, P = 0 .02), and diabetic (OR 1.62, P = 0 .01) compared with those who received LDLT. Additionally, those receiving MP were less likely to have moderate (OR 0.1, P \u003C 0 .01) or good (OR 0.1, P \u003C 0.01) function status. Despite a worse preoperative condition, patients with MP had a significantly shorter length of stay than those who underwent LDLT (mean 9.6 days vs. 15.8 days, P \u003C 0 .01) with comparable graft failure rates (MP 3. 1% vs. LDLT 3.6%, P = 0 . 7) . Additionally, in those patients with available follow-up data, rehospitalization rates were similar between the two groups (MP 43.8% vs. LDLT 43.3%, P = 0 .89) .  \nConclusions: Increased competition for organs after the implementation of acuity circle allocation has resulted in decreased rates of transplantation for HCC. LDLT has been one solution to increase access and remains a viable option for some patients. Conversely, MP may help centers offer organs to patients who are non-ideal living donor candidates without concern for worse outcomes.  \nCategories: Transplantation  \nKeywords: hepatocellular carcinome, liver transplantation, living donor liver transplantation, machine perfusion, transplant waitlist  \nIntroduction  \nHepatocellular carcinoma (HCC) is estimated to be the primary cause in more than 80% of primary liver cancers worldwide [1] . For patients with HCC within Milan criteria, liver transplantation is the most definitive option as it provides treatment for both their malignancy and underlying liver disease. Recentchanges in organ allocation have resulted in decreased transplants for patients with HCC [2] . Patients with HCC now have lower top 5 and top 10 offer rates and higher donation after circulatory death (DCD) offer rates [2] . Given that the demand for organs far outweighs the supply, and priority has shifted away from patients with HCC, transplant centers have needed to shift focus to expanding the donor pool. Two such strategies are through the utilization of an organ with perceived lower quality, and the other is through the utilization of living-donor liver transplantation (LDLT) .  \nTraditional methods of static cold storage (SCS) for liver preservation from deceased donors have failed to meet the current demand, as this method results in ischemic graft injury and does not allow clinicians the ability to assess graft function before implantation [3] . As a result, DCD organs, as well as donors for nonide","cbCail28KZ7Uqjz5","https://ap.wps.com/l/cbCail28KZ7Uqjz5","pdf",365234,"English","# Abstract\n## Background\n## Methodology\n## Results\n## Conclusions\n# Introduction\n# Materials And Methods\n## Methodology","[{\"question\":\"What comparison does the study make between liver transplantation approaches?\",\"answer\":\"The study compares living-donor liver transplantation (LDLT) with machine perfusion (MP) for patients with hepatocellular carcinoma (HCC).\"},{\"question\":\"How did patient characteristics differ between MP and LDLT groups?\",\"answer\":\"Patients receiving MP were more likely to be older, obese, and diabetic, and they had lower function status compared with those receiving LDLT.\"},{\"question\":\"What outcomes were similar and what outcomes differed between MP and LDLT?\",\"answer\":\"MP was associated with a significantly shorter length of stay than LDLT, while graft failure rates were comparable and rehospitalization rates were similar in available follow-up data.\"}]","Characterization of Current Utilization of Machine Perfusion and Living-Donor Liver Transplantation for Hepatocellular Carcinoma | PDF",1790613631,25]