Special Populations: Hepatocellular Carcinoma Risk and Liver Transplantation.

Metabolic dysfunction-associated steatotic liver disease/metabolic dysfunction-associated steatohepatitis (MASLD/MASH) is becoming a leading contributor to hepatocellular carcinoma (HCC) globally. This is particularly evident among adults with HCC undergoing liver transplantation. The majority of patients with MASLD/MASH-related HCC have cirrhosis, but existing data suggest that up to 40% of patients do not have obvious cirrhosis. Early detection of HCC leads to improved curative options, but current guidelines recommend routine HCC surveillance only in patients with cirrhosis. An individualized approach is needed when considering HCC surveillance in MASLD/MASH patients without clinical cirrhosis.