Effect of the HCC Liver-Link Intervention

Inclusion criteria

• Within UCSF criteria:

Candidates are eligible or a standardized MELD or PELD exception if, before completing locoregional therapy, they have lesions that meet one of the following criteria:

• One Class 5 lesion greater than 5 cm and less than or equal to 8 cm
• two or three Class 5 lesions that meeting all of the following

• At least one lesion greater than 3cm
• Each lesion less than or equal to 5 cm, and
• A total diameter of all lesions less than or equal to 8cm
• Four or five Class 5 lesions each less than 3 cm, and a total diameter of all lesions less than or equal to 8 cm.
• Between 18-75 years old
• Have no more than two visits with an HCC-related provider
• Able to read, write, and speak English
• Any 1 of the following:

• Self-report as Black race (can be multiple races as long as 1 is Black)
• Self-report as insured by Medicaid (+/- Medicare)
• SVI (Social vulnerability index) >= .75
• Unmarried

Exclusion criteria

• Lacks capacity to provide informed consent, including those with stage 2 HE or higher at the time of consent.
• Age over 75
• Last transthoracic echocardiogram with EF<40% (OK if no prior echo)
• BMI over 50
• Patients who, in the investigator's judgment, are unlikely to ever be eligible for liver transplantation or resection at the time of enrollment, with reason documented
• Prior history of any solid organ transplant
• Non-skin cancer malignancies other than hepatocellular carcinoma in past 2 years unless approved by PI (i.e. cervical cancer, early prostate cancer)
• Patients who have undergone resection or waitlisted
• Patients near completion of transplant evaluation, PI to determine utility of intervention.