Liver Lineup: Bridging Innovation and Practice in Liver Transplant and HCC Care

In this episode of Liver Lineup: Updates and Unfiltered Insights, hosts Kimberly Brown, MD, and Nancy Reau, MD, break down new research on liver transplantation, hepatocellular carcinoma (HCC), and the ongoing evolution of surveillance strategies in chronic liver disease. Drawing on their extensive experience as transplant hepatologists, Brown and Reau place new data into practical context, highlighting where evidence may meaningfully inform practice and where unanswered questions remain.Key episode timestamps:0:00:00 – Introduction0:00:19 – Frailty & Transplant Evaluation0:02:54 – How Centers Use Frailty Measures0:04:37 – Practicalities of the Six‑Minute Walk0:06:10 – MELD 3.0 and Sex/Size Disparities0:08:42 – Exception Points & Size Constraints0:10:05 – Need for a Dynamic MELD System0:10:19 – Immunotherapy as Bridge/Downstaging for HCC0:13:34 – Real‑World Use of IO Around Transplant0:15:22 – Managing Rejection Risk0:19:03 – MASLD Population & Surveillance Gaps0:20:21 – Adherence to HCC Surveillance0:22:42 – Practical Barriers: AFP, Ultrasound, Radiology Reports0:24:02 – Shift Toward Blood-Based Surveillance0:26:01 – How AFP-L3 and DCP Are Used in Practice0:27:39 – Rising AFP, Imaging Strategy & Broader Trend to Blood Tests0:28:27 – Guidelines vs Real-World Practice0:29:37 – Closing Thoughts on Guidelines & Early Detection