Prior reports using DBD livers identified several predictive factors for post-OLT HCC recurrence, such as advanced donor age25,26, diabetes mellitus, severe donor steatosis18, WIT > 50 min17,27, CIT > 10 h27, increased tumor size and number20,21,25, vascular invasion27,28, poor tumor differentiation27,29, elevated pre-OLT AFP, exceeding Milan criteria27, grafts from a non-local share distribution21, and unfavorable tumor biology on pre-OLT imaging17. Here, AFP is linked to hepatocellular carcinoma.