{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T09:49:27Z","timestamp":1782121767982,"version":"3.54.5"},"reference-count":34,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T00:00:00Z","timestamp":1782086400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T00:00:00Z","timestamp":1782086400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["22K15991"],"award-info":[{"award-number":["22K15991"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["25K11248"],"award-info":[{"award-number":["25K11248"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Hepatology Research"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>In Japan, liver transplantation (LT) for hepatocellular carcinoma (HCC) is restricted to patients with decompensated cirrhosis. We investigated the clinical course, prognosis, and medical expenditure of patients with Child\u2013Pugh class A (CP\u2010A) HCC initially within the Japan criteria, including changes in oncological eligibility for LT during follow\u2010up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed patients with HCC treated at Kanazawa University Hospital between 2011 and 2021. After applying the age criterion (&lt;\u00a070\u00a0years), 134 patients with CP\u2010A HCC, 45 with CP\u2010B HCC, and 6 LT recipients were included. Survival and cumulative HCC\u2010related medical expenditures were compared. A transplantable period was defined as the interval during which both hepatic reserve and tumor burden met LT eligibility.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>LT achieved the most favorable prognosis, with a 5\u2010year overall survival rate of 83.3%. Among patients with CP\u2010A HCC, progression beyond the Japan criteria was associated with markedly reduced survival, approaching that observed in CP\u2010B disease. Of 53 patients who progressed beyond the Japan criteria, only 12 (22.6%) retained a transplantable period (median, 10.6\u00a0months). Early recurrence and a FIB\u20104 index &gt;\u00a05 were independently associated with poor prognosis. The cost per treatment life\u2010year did not differ significantly between LT recipients and certain CP\u2010A HCC subgroups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Many patients with CP\u2010A HCC initially within the Japan criteria lost oncological eligibility for LT before hepatic decompensation. Further studies are warranted to determine whether a subset of patients with compensated cirrhosis may benefit from LT and to inform future discussions regarding the potential expansion of LT indications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/hepr.70230","type":"journal-article","created":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T09:09:49Z","timestamp":1782119389000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Potential Role of Liver Transplantation for Child\u2013Pugh Class A Hepatocellular Carcinoma: Prognosis and Medical Expenditure in Japan\u2014A Retrospective Single\u2010Center Study"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0356-1810","authenticated-orcid":false,"given":"Akihiro","family":"Seki","sequence":"first","affiliation":[{"name":"Department of Gastroenterology Kanazawa University Hospital  Kanazawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoyoshi","family":"Chiba","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Kanazawa University Hospital  Kanazawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shintaro","family":"Yagi","sequence":"additional","affiliation":[{"name":"Department of Hepato\u2010Biliary\u2010Pancreatic Surgery and\u00a0Transplantation Kanazawa University Hospital  Kanazawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rika","family":"Horii","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Kanazawa University Hospital  Kanazawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noboru","family":"Takata","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Kanazawa University Hospital  Kanazawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroki","family":"Nomura","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Kanazawa University Hospital  Kanazawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaki","family":"Miyazawa","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Kanazawa University Hospital  Kanazawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoyuki","family":"Hayashi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Kanazawa University Hospital  Kanazawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1052-0101","authenticated-orcid":false,"given":"Takeshi","family":"Terashima","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Kanazawa University Hospital  Kanazawa Japan"},{"name":"Department of Medical Oncology Kanazawa Medical University  Uchinada Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5118-2225","authenticated-orcid":false,"given":"Shinichi","family":"Nakanuma","sequence":"additional","affiliation":[{"name":"Department of Hepato\u2010Biliary\u2010Pancreatic Surgery and\u00a0Transplantation Kanazawa University Hospital  Kanazawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0552-0297","authenticated-orcid":false,"given":"Mitsuyoshi","family":"Okazaki","sequence":"additional","affiliation":[{"name":"Department of Hepato\u2010Biliary\u2010Pancreatic Surgery and\u00a0Transplantation Kanazawa University Hospital  Kanazawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0070-0379","authenticated-orcid":false,"given":"Satoshi","family":"Takada","sequence":"additional","affiliation":[{"name":"Department of Hepato\u2010Biliary\u2010Pancreatic Surgery and\u00a0Transplantation Kanazawa University Hospital  Kanazawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatsuya","family":"Yamashita","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Kanazawa University Hospital  Kanazawa Japan"},{"name":"Public Central Hospital of Matto Ishikawa  Hakusan Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masao","family":"Honda","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Kanazawa University Hospital  Kanazawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hajime","family":"Takatori","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Kanazawa University Hospital  Kanazawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetsuro","family":"Shimakami","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Kanazawa University Hospital  Kanazawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3383-9131","authenticated-orcid":false,"given":"Taro","family":"Yamashita","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Kanazawa University Hospital  Kanazawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,22]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2022.08.021"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199603143341104"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/tri.13391"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/hepr.14168"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.2147\/JHC.S347959"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2015.07.019"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.28368"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(18)30207\u20101"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0708857"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1056\/EVIDoa2100070"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1915745"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/HC9.0000000000000453"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/bjsopen\/zrae079"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.2007.15"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2014.09.018"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/hepr.14033"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers14112662"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600\u20106143.2007.01965.x"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.28643"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.21037\/hbsn.2017.05.14"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2017.09.025"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.21037\/tgh.2020.01.06"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/hepr.14017"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/hepr.14178"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/TXD.0000000000001650"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.3389\/ti.2024.13263"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.21037\/hbsn\u201021\u2010350"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v19.i43.7515"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers14020396"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.21037\/hbsn\u201023\u2010538"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/hepr.13992"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.1186\/2008\u20102231\u201021\u201040"},{"key":"e_1_2_12_34_1","doi-asserted-by":"publisher","DOI":"10.1093\/jjco\/hyae048"},{"key":"e_1_2_12_35_1","doi-asserted-by":"publisher","DOI":"10.1177\/1077558708324299"}],"container-title":["Hepatology Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hepr.70230","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/hepr.70230","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hepr.70230","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T09:09:50Z","timestamp":1782119390000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/hepr.70230"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,22]]},"references-count":34,"alternative-id":["10.1111\/hepr.70230"],"URL":"https:\/\/doi.org\/10.1111\/hepr.70230","archive":["Portico"],"relation":{},"ISSN":["1386-6346","1872-034X"],"issn-type":[{"value":"1386-6346","type":"print"},{"value":"1872-034X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,22]]},"assertion":[{"value":"2025-12-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-12","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-22","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"hepr.70230"}}