Abstract: Background Bridging therapies (BTs) are used extensively prior to liver transplant in patients with hepatocellular carcinoma (HCC); however, uncertainty remains as to their long-term results. This study compared the survival and disease recurrence in patients with HCC who received liver transplants, with and without additional bridging treatments. Methods A retrospective study was performed of 144 patients with HCC who received a liver transplant in a period of 25 years, 95 of whom received a prior treatment as a bridge to transplant. Results The most frequently used BT was thermoablation (72.7%), of which 63.2% was radiofrequency and 9.5% microwave ablation. Uni- and multivariable analysis did not find statistically significant differences in survival between the BT and non-BT groups, with a mean (standard deviation) survival of 53.2 (1.181) months vs 54.1 (2.61) months, respectively. Neither were there significant differences in the time to recurrence, with a mean of 27 (9.86) months for BT vs 33.25 (8.6) months for the transplant-only group. There were no significant differences between different types of BT in terms of survival. The mean survival in those patients who received radiofrequency ablation was 51.5 (2.4) months vs 45.8 (7.57) months for those who received microwave ablation. Conclusions No differences were found between those transplant recipients with HCC who underwent treatment prior to transplant and those who did not, either in terms of survival or recurrence at 5 years.

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