Recent advances made in liver transplantation for HCC


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.)