Hepatocellular carcinoma: indications for liver transplantation


Prof. A. K. Burroughs, Liver Transplantation and Hepatobiliary Medicine, Royal Free Hospital NHS Trust, Pond Street, London NW3 2QG, UK.
E-mail: andrew.burroughs@talk21.com


The role of liver transplantation for hepatocellular carcinoma has evolved over the years and currently is one of the curative therapies for small tumours. The survival rates are similar with those for nonmalignant liver disease after transplantation. The treatment of small tumours eligible for both resection and transplantation depends on the experience of the transplant centre and the waiting time for a liver graft. With waiting times for liver transplant becoming gradually longer, prioritization of the tumour patients has been suggested. Adjuvant therapies may delay the tumour progression while patients wait for a transplant. The living donor and the domino liver transplantation are useful alternatives given the shortage of organs but the experience is still limited in the Western world and the selection for the domino livers is fairly restricted.