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Digestive Disease Interventions
DOI: 10.1055/s-0044-1791837
Review Article

Locoregional Therapies and Interventional Radiology in Managing Hepatocellular Carcinoma: A Comprehensive Approach to Bridging, Downstaging, and Liver Transplantation

Juana V. Barrera
1   Interventional Radiology Department, School of Medicine, University of California San Francisco, San Francisco, California
,
Leonard Dallag
2   Interventional Radiology Department, University of Miami, Miami, Florida
,
Rubeel Akram
3   Interventional Radiology Department, UT Southwestern Medical Center, Dallas, Texas
,
Jason Salsamendi
4   Interventional Radiology Department, City of Hope, Los Angeles, California
,
Camilo Barragan 
5   Interventional Radiology Department, University of Toronto, Toronto, Canada
,
Chase J. Wehrle
6   Interventional Radiology Department, Cleveland Clinic, Cleveland, Ohio
,
Jamaal Benjamin
3   Interventional Radiology Department, UT Southwestern Medical Center, Dallas, Texas
,
Maria del Pilar Bayona Molano
2   Interventional Radiology Department, University of Miami, Miami, Florida
› Author Affiliations Funding This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
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Abstract

Hepatocellular carcinoma (HCC) remains a significant global health challenge, particularly for patients awaiting liver transplants (LTs) due to the scarcity of donor organs. During the waiting period, a multidisciplinary approach becomes crucial to optimize tumor treatment and preserve liver function. In recent years, interventional radiology has emerged as an integral part of treatment strategies. It has played a pivotal role in bridging and downstaging patients on the path to transplantation. Interventional radiologists administer minimally invasive locoregional therapies to HCC patients on LT waiting lists. Additionally, they address complications such as portal hypertension and portal vein thrombosis, which can lead to clinical deterioration and jeopardize transplant candidacy. This article examines the pivotal role of interventional radiology in the management of HCC, highlighting recent studies and advancements within the field. Additionally, it provides a concise review of the eligibility criteria for LT in patients with HCC, alongside a discussion of the surgical techniques employed in LT for these patients.

Keywords

hepatocellular carcinoma - interventional radiology - locoregional therapy

Ethical Approval and Consent to Participate

This review did not require institutional review board's approval. The research satisfied all three requirements for a waiver of authorization under 45 Code of Federal Regulations 164.512.


Consent for Publication

Not applicable.


Availability of Data and Materials

The datasets generated and/or analyzed during the current study are not publicly available but are available from the corresponding author on a reasonable request.


Competing Interests

The authors have no relevant financial or nonfinancial interests to disclose.


Preprint Publication

Not applicable.


Authorship

J.V.B., L.D., R.A., J.S., C.B., C.J.W., and M.P.B.M. contributed to the conception and design of the work, acquisition, and interpretation of data, and substantively revised the work. In addition, J.V.B. contributed with the edition and grammar style. L.D., J.S., and C.J.W. made contributions to the conception of the work. R.A. with data collection, M.P.B.M. made contributions with revision and approval of the work. All authors read and approved the final manuscript.




Publication History

Received: 21 September 2024

Accepted: 25 September 2024

Article published online:
21 October 2024

© 2024. Thieme. All rights reserved.

Thieme Medical Publishers
333 Seventh Avenue, New York, NY 10001, USA.

 

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