Kwong AJ, Ghaziani TT, Yao F, et al. - Locoregional therapy (LRT), particularly radioembolization, was increasingly used to bridge to liver transplant (LT) in a large nationwide cohort of LT candidates with hepatocellular carcinoma (HCC).

• Patients with a higher tumor burden and more compensated liver disease received more treatments while waiting for LT.

• Findings suggested an association of bridging LRT with a lower risk of waitlist dropout.

• There were 31,609 eligible patients and 34,610 treatments among 24,145 LT candidates with at least one approved HCC exception.

• The proportion of people who used at least one LRT increased from 42.3% in 2003 to 92.4% in 2018.

• Chemoembolization is still the most common type, followed by thermal ablation, with radioembolization increasing from 3% in 2013 to 19% in 2018.

• Patients with tumor burden greater than Milan, higher alpha-fetoprotein, and more compensated liver disease had a higher incidence of LRT.

• The receipt of any type of LRT was linked to a lower risk of waitlist dropout; there were no significant differences based on the number of LRT received.

• When compared with chemoembolization, radioembolization or ablation as the first LRT was associated with a lower risk of waitlist dropout in an IPTW-adjusted analysis.