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.