Yttrium-90 radioembolization therapy prior to liver transplantation for hepatocellular carcinoma improves patient outcomes

Hepatobiliary Pancreat Dis Int. 2026 Feb;25(1):4-14. doi: 10.1016/j.hbpd.2025.11.003. Epub 2025 Nov 4.

Abstract

For early hepatocellular carcinoma (HCC), curative therapies include surgical excision and radiofrequency ablation. Other treatment modes for advanced HCC involve transarterial chemoembolization. For HCC patients who do not fit the Milan criteria or are waiting for liver transplantation (LT), studies of transarterial radioembolization with Yttrium-90 (Y-90) demonstrated that Y-90 may accomplish a good downstaging or bridging effect before LT and can even achieve complete pathological necrosis. The present review discussed Y-90 radioembolization as a local regional treatment option for advanced and unresectable HCC, with a focus on neoadjuvant intervention before LT.

Keywords: Hepatocellular carcinoma; Liver transplantation; Transarterial chemoembolization; Transarterial radioembolization; Yttrium-90.

Publication types

  • Review

MeSH terms

  • Carcinoma, Hepatocellular* / mortality
  • Carcinoma, Hepatocellular* / pathology
  • Carcinoma, Hepatocellular* / radiotherapy
  • Carcinoma, Hepatocellular* / surgery
  • Carcinoma, Hepatocellular* / therapy
  • Embolization, Therapeutic* / adverse effects
  • Embolization, Therapeutic* / methods
  • Humans
  • Liver Neoplasms* / mortality
  • Liver Neoplasms* / pathology
  • Liver Neoplasms* / radiotherapy
  • Liver Neoplasms* / surgery
  • Liver Neoplasms* / therapy
  • Liver Transplantation*
  • Neoadjuvant Therapy* / methods
  • Radiopharmaceuticals* / administration & dosage
  • Radiopharmaceuticals* / adverse effects
  • Radiopharmaceuticals* / therapeutic use
  • Treatment Outcome
  • Yttrium Radioisotopes* / administration & dosage
  • Yttrium Radioisotopes* / adverse effects
  • Yttrium Radioisotopes* / therapeutic use

Substances

  • Yttrium Radioisotopes
  • Yttrium-90
  • Radiopharmaceuticals