Dr. Humar presented a case review favored liver transplant over surgery for multifocal HCC with portal hypertension, highlighting bridging therapy, Milan criteria, neoadjuvant immunotherapy, and expanded transplant access.

Dr. William Jarnagin presented a case of large HCC highlighted personalized care, with Y90 downsizing enabling successful resection. The patient remained disease-free at 14 months, supporting multimodal treatment strategies.

Dr. Singal presented a case of advanced HCC showed immunotherapy can downstage select patients to transplant eligibility, achieving long-term disease-free survival despite initial vascular invasion.

Dr. El-Khoueiry presented a patient with advanced HCC achieved major pathologic response after nivolumab/ipilimumab, enabling surgery. The case highlighted immunotherapy, immune hepatitis management, and imaging-pathology discordance.

Dr. Malla presented a recurrent HCC case highlighted durable response to atezolizumab/bevacizumab, challenges of immune-related colitis and hepatitis, and careful decisions on immunotherapy rechallenge.

Experts concluded transplant is rarely appropriate for metastatic HCC. Immunotherapy offers durable responses, but post-transplant use carries high rejection risk; SBRT and neoadjuvant therapy may help.