| Recent advances made in liver transplantation for HCC | ||
Established | Under discussion | Under trial or proposal | |
Criteria for listing candidate | The milan criteria : solitary tumor of ≤5 cm or up to 3 nodules ≤ 3 cm 5-yr survival of 70% with Recurrence in less than 10% | The UCSF criteria: Single tumor ≤ 6.5 cm or 2 - 3 tumors ≤ 4.5 cm with a total tumor diameter ≤ 8 cm | Add parameters for biologic features of tumors related to risk of recurrence (AFP, PIVKA-II, etc.) |
Management on the waiting list (about 40% dropout rate at 12 mo) | Local ablation therapy and TACE are performed without solid evidence | Different models have been developed to quantify the risk of death in neoplastic and non-neoplastic patients Association with liver resection. “bridging resection “to transplantation and “salvage transplantation” following resection | Application of living donor-LT to shorten the waiting time Candidate selection with information from precedent therapy (histologic specimen, response to locoregional therapy, etc.) |