diff --git a/base/compiler/ssair/passes.jl b/base/compiler/ssair/passes.jl
index 000bb1849edea..0a1badff94baf 100644
--- a/base/compiler/ssair/passes.jl
+++ b/base/compiler/ssair/passes.jl
@@ -852,13 +852,17 @@ function sroa_mutables!(ir::IRCode, defuses::IdDict{Int, Tuple{SPCSet, SSADefUse
         typ = typ::DataType
         # Partition defuses by field
         fielddefuse = SSADefUse[SSADefUse() for _ = 1:fieldcount(typ)]
+        all_forwarded = true
         for use in defuse.uses
             stmt = ir[SSAValue(use)] # == `getfield` call
             # We may have discovered above that this use is dead
             # after the getfield elim of immutables. In that case,
             # it would have been deleted. That's fine, just ignore
             # the use in that case.
-            stmt === nothing && continue
+            if stmt === nothing
+                all_forwarded = false
+                continue
+            end
             field = try_compute_fieldidx_stmt(ir, stmt::Expr, typ)
             field === nothing && @goto skip
             push!(fielddefuse[field].uses, use)
@@ -928,7 +932,12 @@ function sroa_mutables!(ir::IRCode, defuses::IdDict{Int, Tuple{SPCSet, SSADefUse
             end
         end
         preserve_uses === nothing && continue
-        push!(intermediaries, newidx)
+        if all_forwarded
+            # this means all ccall preserves have been replaced with forwarded loads
+            # so we can potentially eliminate the allocation, otherwise we must preserve
+            # the whole allocation.
+            push!(intermediaries, newidx)
+        end
         # Insert the new preserves
         for (use, new_preserves) in preserve_uses
             ir[SSAValue(use)] = form_new_preserves(ir[SSAValue(use)]::Expr, intermediaries, new_preserves)
@@ -938,7 +947,7 @@ function sroa_mutables!(ir::IRCode, defuses::IdDict{Int, Tuple{SPCSet, SSADefUse
     end
 end
 
-function form_new_preserves(origex::Expr, preserved::Vector{Int}, new_preserves::Vector{Any})
+function form_new_preserves(origex::Expr, intermediates::Vector{Int}, new_preserves::Vector{Any})
     newex = Expr(:foreigncall)
     nccallargs = length(origex.args[3]::SimpleVector)
     for i in 1:(6+nccallargs-1)
@@ -946,7 +955,8 @@ function form_new_preserves(origex::Expr, preserved::Vector{Int}, new_preserves:
     end
     for i in (6+nccallargs):length(origex.args)
         x = origex.args[i]
-        if isa(x, SSAValue) && x.id in preserved
+        # don't need to preserve intermediaries
+        if isa(x, SSAValue) && x.id in intermediates
             continue
         end
         push!(newex.args, x)
diff --git a/test/compiler/irpasses.jl b/test/compiler/irpasses.jl
index dbffa41edc7ae..05fb890f91848 100644
--- a/test/compiler/irpasses.jl
+++ b/test/compiler/irpasses.jl
@@ -672,3 +672,35 @@ let
         return Core.Compiler.widenconst(ft) !== typeof(typeassert)
     end
 end
+
+let
+    # Test for https://github.com/JuliaLang/julia/issues/43402
+    # Ensure that structs required not used outside of the ccall,
+    # still get listed in the ccall_preserves
+
+    src = @eval Module() begin
+        @inline function effectful()
+            s1 = Ref{Csize_t}()
+            s2 = Ref{Csize_t}()
+            ccall(:some_ccall, Cvoid,
+                  (Ref{Csize_t},Ref{Csize_t}),
+                  s1, s2)
+            return s1[], s2[]
+        end
+
+        code_typed() do
+            s1, s2 = effectful()
+            return s1
+        end |> only |> first
+    end
+
+    refs = map(Core.SSAValue, findall(x->x isa Expr && x.head == :new, src.code))
+    some_ccall = findfirst(x -> x isa Expr && x.head == :foreigncall && x.args[1] == :(:some_ccall), src.code)
+    @assert some_ccall !== nothing
+    stmt = src.code[some_ccall]
+    nccallargs = length(stmt.args[3]::Core.SimpleVector)
+    preserves = stmt.args[6+nccallargs:end]
+    @test length(refs) == 2
+    @test length(preserves) == 2
+    @test all(alloc -> alloc in preserves, refs)
+end