The MATCH trial's four-year data, published in Cell Stem Cell, reports that autologous macrophage therapy raised transplant-free survival from 40% to 70% in patients with advanced cirrhosis (n=50 total). This open-label study allocated 26 participants to macrophage infusion and 24 to standard care, recording eight deaths and zero transplants in the treatment arm versus nine deaths and five transplants in controls. While the University of Edinburgh-led work, developed with SNBTS and Resolution Therapeutics, demonstrates biological plausibility—macrophages appear to degrade scar tissue and dampen inflammation—the modest sample size and lack of blinding introduce risks of selection and reporting bias. An earlier 2021 phase 1 safety study (Forbes et al., Nature Medicine) similarly flagged tolerability but could not assess efficacy. Larger, multicenter RCTs such as the ongoing EMERALD trial of RTX001 will be essential to confirm durability and generalizability. Conflicts of interest are notable: senior author Stuart Forbes co-founded Resolution Therapeutics, which stands to commercialize the approach. If replicated, macrophage therapy could ease pressure on scarce donor livers, yet current evidence remains hypothesis-generating rather than practice-changing.