Innovative Diagnosis and Therapy in LDLT Patients With High-risk Hepatocellular Carcinoma

This study tests an innovative treatment approach for people with high-risk liver cancer (hepatocellular carcinoma) who are receiving a living-donor liver transplant (LDLT). High-risk patients are those whose tumors don't meet standard criteria for transplant (e.g., tumors are too large or numerous). Researchers are testing whether adding targeted therapy (lenvatinib) after transplant can reduce the risk of the cancer coming back. **You may be eligible if...** - You are receiving a liver transplant from a living donor - You have high-risk liver cancer based on defined criteria: positive PET scan before transplant, tumors beyond UCSF criteria, poorly differentiated tumors, or poor AFP response to prior local treatment - You can tolerate the immunosuppressive and targeted therapy regimen **You may NOT be eligible if...** - Your life expectancy is less than 3 months - You have another active cancer at the same time - You are allergic to lenvatinib or its inactive ingredients Talk to your doctor to see if this trial is right for you.