Beau Bosko Toskich, Professor of Radiology and Director of Interventional Oncology at Mayo Clinic Florida, posted on X:

“MERITS-LT: Downstaging hepatocellular carcinoma patients outside of UNOS-DS criteria (aka “all comers” or AC) results in similar post-transplant survival to those within criteria (3-year 91% vs 81%, P = .67).

What is your MDT using most commonly to downstage patients with HCC?

91.7% of respondents reported that their multidisciplinary team (MDT) most commonly uses TARE (Transarterial Radioembolization). TACE (Transarterial Chemoembolization) was chosen by 8.3%, while EBRT (External Beam Radiotherapy) and Systemic Therapy received 0% of the votes.”

The MERITS-LT study demonstrates that patients with hepatocellular carcinoma (HCC) who are downstaged outside the standard UNOS-DS criteria can achieve post-transplant survival comparable to those within the criteria, with a reported 3-year survival of 91% versus 81% respectively (P = .67). The majority of multidisciplinary teams (MDTs) reported using transarterial radioembolization (TARE) for downstaging, with limited use of TACE and no reported use of EBRT or systemic therapy.

“Downstaging hepatocellular carcinoma before liver transplantation: A multicenter analysis of the “all-comers” protocol in the Multicenter Evaluation of Reduction in Tumor Size before Liver Transplantation (MERITS-LT) consortium.”

Authors: Brahma Natarajan, Parissa Tabrizian, Maarouf Hoteit, Catherine Frenette, Neehar Parikh, Tara Ghaziani, Renu Dhanasekaran, Jennifer Guy, Amy Shui, Sander Florman, Francis Y. Yao, Neil Mehta

Beau Bosko Toskich: MERITS-LT Trial Shows Comparable Survival for HCC Patients Outside UNOS Criteria