{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T18:27:06Z","timestamp":1786991226996,"version":"build-2736575974"},"reference-count":20,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T00:00:00Z","timestamp":1786924800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T00:00:00Z","timestamp":1786924800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Surgical Oncology"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>In liver transplantation (LT) with a caval sparing (CS) approach, the presence of complete encirclement of inferior vena cava (IVC\u2010E) by hypertrophic segment 1 increases the technical complexity of hepatectomy. Thus, in LT for hepatocellular carcinoma (HCC), It may be suspected that the resulting greater liver manipulation and delayed vascular exclusion might increase the risk of intraoperative dissemination of tumor cells.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A multicenter, retrospective study was performed to assess the association between IVC\u2010E and the risk of post\u2010transplant tumor recurrence in a cohort of 537 HCC patients treated with CS\u2010LT, between 2010 and 2021. IVC\u2010E was defined on preoperative imaging.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      IVC\u2010E (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009150) and no\u2010IVC\u2010E (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009387) groups were comparable in terms of severity of underlying liver disease, recipient characteristics, morphological and biological features of HCC. Recipient hepatectomy was significantly longer in IVC\u2010E group (IVC\u2010E vs. no\u2010IVC\u2010E, 144\u2009min [110\u2013180] versus 120\u2009min [90\u2013150],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and was associated with higher blood transfusion requirements (no transfusion cases, 15.3% vs. 25.8%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.034). The cumulative incidence of HCC recurrence at 1, 3, and 5\u2010year, accounting for the competing risk of death unrelated to tumor recurrence, was significantly higher in IVC\u2010E group (8.1%, 18.5%, and 20.1% vs. 3.9%, 8.4%, and 11.3%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001, respectively).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The technical complexity associated with IVC\u2010E during CS hepatectomy not only increases intraoperative morbidity but may also trigger the risk of post\u2010transplant tumor recurrence in LT for HCC.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jso.70375","type":"journal-article","created":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T17:36:12Z","timestamp":1786988172000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Retrohepatic Vena Cava Encirclement, as Surrogate of Extensive Liver Manipulation During Caval Sparing Hepatectomy, Is a Risk Factor for Tumor Recurrence After Liver Transplantation for Hepatocellular Carcinoma"],"prefix":"10.1002","author":[{"given":"Riccardo","family":"Pravisani","sequence":"first","affiliation":[{"name":"Department of Medicine, Liver\u2010Kidney Transplant Unit University of Udine Udine Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudio","family":"Bosio","sequence":"additional","affiliation":[{"name":"USD Trapianti Epatici, AUOI Verona Verona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grazia","family":"Conte","sequence":"additional","affiliation":[{"name":"Department of Experimental and Clinical Medicine, HPB and Transplantation Unit, United Hospital of Ancona Polytechnic University of Marche Ancona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex","family":"Borin","sequence":"additional","affiliation":[{"name":"USD Trapianti Epatici, AUOI Verona Verona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amedeo","family":"Carraro","sequence":"additional","affiliation":[{"name":"USD Trapianti Epatici, AUOI Verona Verona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Mocchegiani","sequence":"additional","affiliation":[{"name":"Department of Experimental and Clinical Medicine, HPB and Transplantation Unit, United Hospital of Ancona Polytechnic University of Marche Ancona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria De","family":"Martino","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Medical Statistic University of Udine Udine Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Vivarelli","sequence":"additional","affiliation":[{"name":"Department of Experimental and Clinical Medicine, HPB and Transplantation Unit, United Hospital of Ancona Polytechnic University of Marche Ancona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dario","family":"Lorenzin","sequence":"additional","affiliation":[{"name":"Department of Medicine, Liver\u2010Kidney Transplant Unit University of Udine Udine Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6935-438X","authenticated-orcid":false,"given":"Umberto","family":"Baccarani","sequence":"additional","affiliation":[{"name":"Department of 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Personalised Management of Patients With Hepatocellular Carcinoma: A Multiparametric Therapeutic Hierarchy Concept","volume":"24","author":"Vitale A.","year":"2023","journal-title":"The Lancet Oncology(London)"},{"issue":"2","key":"e_1_2_11_13_1","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1016\/j.jhep.2024.08.028","article-title":"EASL Clinical Practice Guidelines on the Management of Hepatocellular Carcinoma","volume":"82","author":"European Association for the Study of the Liver","year":"2025","journal-title":"Journal of Hepatology"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.16720"},{"issue":"6","key":"e_1_2_11_15_1","doi-asserted-by":"crossref","DOI":"10.1097\/TXD.0000000000001646","article-title":"No\u2010Touch\u201d Left Approach for Recipient Hepatectomy: A Promising Strategy to Minimize Hepatocellular Carcinoma Recurrence in Liver Transplantation","volume":"10","author":"Yang S.","year":"2024","journal-title":"Transplantation Direct"},{"issue":"9","key":"e_1_2_11_16_1","doi-asserted-by":"crossref","first-page":"1380","DOI":"10.1002\/lt.21503","article-title":"Left\u2010to\u2010Right Approach Facilitates Total Hepatectomy With Caval Flow Preservation","volume":"14","author":"Dond\u00e9ro F.","year":"2008","journal-title":"Liver Transplantation"},{"issue":"4","key":"e_1_2_11_17_1","doi-asserted-by":"crossref","first-page":"974","DOI":"10.1016\/j.surg.2020.09.036","article-title":"The Learning Curve for Piggyback Liver Transplantation: Identifying Factors Challenging Surgery","volume":"169","author":"Addeo P.","year":"2021","journal-title":"Surgery"},{"issue":"1","key":"e_1_2_11_18_1","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1016\/j.hbpd.2024.10.004","article-title":"No\u2010Touch Recipient Hepatectomy in Liver Transplantation for Liver Malignancies: A State\u2010of\u2010the\u2010Art Review","volume":"24","author":"Xu S. 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