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Abstract Details
Risk assessment criteria in liver transplantation for hepatocellular carcinoma: proposal to improve transplant oncology
1Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH 44113, USA.
2Gastrointestinal & Thoracic Malignancy Section, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA.
3Department of General Surgery, Digestive Disease & Surgery Institute, Cleveland Clinic, Cleveland, OH 44113, USA.
4Department of Surgery, Duke University School of Medicine, Durham, NC 27705, USA.
Abstract
Liver transplantation for hepatocellular carcinoma has proved to be a highly effective cure if the right patient can be selected. Milan criteria has traditionally guided physicians toward appropriate liver allocation but changes in clinical practice, patient populations and recent developments in biomarkers are decreasing Milan criteria's utility. At the same time, the literature has flooded with a diversity of new criteria that demonstrate strong predictive power and are better suited for current clinical practice. In this article, the utility of newly proposed criteria will be reviewed and important issues to improve future criteria will be addressed in hopes of opening a discussion on how key questions surrounding criteria for liver transplantation of hepatocellular carcinoma can be answered.