Selection of patients with hepatocellular carcinoma for liver transplantation
Article first published online: 2 DEC 2005
Copyright © 2005 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
British Journal of Surgery
Volume 93, Issue 1, pages 11–18, January 2006
How to Cite
Sutcliffe, R., Maguire, D., Portmann, B., Rela, M. and Heaton, N. (2006), Selection of patients with hepatocellular carcinoma for liver transplantation. Br J Surg, 93: 11–18. doi: 10.1002/bjs.5198
- Issue published online: 21 DEC 2005
- Article first published online: 2 DEC 2005
- Manuscript Accepted: 14 AUG 2005
Orthotopic liver transplantation (OLT) plays a pivotal role in the management of selected patients with initial hepatocellular carcinoma (HCC). After disappointing early results and a shortage of cadaveric grafts, patients are currently selected for OLT on the basis of tumour size and number. Limitations of these criteria and the advent of living donation have prompted their re-evaluation. The principal aims of this review were to define the limitations of current transplant criteria for HCC, and to identify potential areas for improvement.
A Medline search using the terms ‘liver transplantation’ and ‘hepatocellular carcinoma’ was conducted. Additional references were sourced from key articles.
Results and conclusion:
In patients with HCC, biological properties of the tumour are more accurate than radiological criteria in determining outcome after transplantation. Despite the risks of tumour biopsy, which may have been previously overstated, histological evaluation before transplantation may have a role and warrants further study. By expanding the donor pool and eliminating waiting times, live donor liver transplantation is a valuable resource that has yet to fulfil its potential because of unresolved ethical issues concerning the safety of the donor. The availability of long-term outcome data may help to clarify this in the near future. Copyright © 2005 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.