Backgrounds: Hepatocellular carcinoma (HCC) recurrence after liver transplantation remains a significant concern. This study investigated the impact of ABO blood type on HCC recurrence and overall survival in individuals after living donor liver transplantation (LDLT) using data from the Korean Organ Transplantation Registry. Materials and Methods: A retrospective analysis of 2380 LDLT patients from the KOTRY database (2014–2021) was conducted. Clinical outcomes were compared across ABO blood types using Kaplan–Meier survival and multivariate Cox regression analyses. Results: ABO blood type did not significantly affect HCC recurrence or overall survival. Multivariate analysis demonstrated that only the Milan criteria were closely associated with HCC recurrence. Overall survival was dependent on the Milan criteria and ABO incompatibility in multivariable analysis. Patients beyond the Milan criteria with ABO-incompatibility had worse recurrence-free survival and overall survival compared with other groups. Conclusions: ABO blood type does not predict HCC recurrence or overall survival. Clinical factors like beyond the Milan criteria and ABO-incompatibility remain critical in managing LDLT patients with HCC.
KIM et al. (2026) studied this question.