Selection of candidates with HCC for transplantation in the MELD era

Authors

  • Margarita Sala,

    1. Barcelona-Clinic-Liver-Cancer Group, Liver Unit, Hospital Clínic, University of Barcelona, Barcelona, Spain
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  • Maria Varela,

    1. Barcelona-Clinic-Liver-Cancer Group, Liver Unit, Hospital Clínic, University of Barcelona, Barcelona, Spain
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  • Jordi Bruix

    Corresponding author
    1. Barcelona-Clinic-Liver-Cancer Group, Liver Unit, Hospital Clínic, University of Barcelona, Barcelona, Spain
    • BCLC Group, Liver Unit, Hospital Clínic, University of Barcelona, IDIBAPS Villarroel, 17008036 Barcelona, Spain
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    • Telephone: 34 93 227 9803; Fax: 34 93 227 5792


Abstract

Key Points

  • 1Liver transplantation is the main option for patients with early HCC who are not optimal candidates for surgical resection.
  • 2Shortage of donors is its main limitation, as waiting for a liver allows the tumor to progress and induce exclusion from the waiting list and death.
  • 3The absence of randomized controlled trials hinders the establishment of the most effective therapy to prevent tumor progression while waiting.
  • 4Live donation may be a cost-effective approach if optimal results are expected and the mortality risk for the donor is kept below .3%.
  • 5Priority policies have to be developed and refined to provide a fair and effective distribution of cadaveric organs. (Liver Transpl 2004;10:S4–S9.)

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