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Transplantation for Hepatocellular Carcinoma: The North American Experience

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Multidisciplinary Treatment of Hepatocellular Carcinoma

Part of the book series: Recent Results in Cancer Research ((RECENTCANCER,volume 190))

Abstract

Liver transplantation for hepatocellular carcinoma (HCC) in North America has undergone substantial change since its inception. Transplantation for large tumors led to near universal tumor recurrence and despite its theoretical benefit, complete liver replacement for primary hepatic malignancy was all but abandoned outside of clinical trials. With the publication of the Milan criteria interest was renewed and results of transplant for HCC began to mirror those for non-malignant indications. The adoption of MELD-based allocation led to a substantial increase in the number of transplants for HCC as MELD priority points were given to patients who met the restrictive criteria. As results of transplantation improved, several groups have pushed the boundaries of Milan and found similar results. To further possibility of transplantation for patients with tumors outside of criteria, locoregional therapies have been utilized to downstage these tumors. As the number of patients awaiting a deceased donor allograft continues to increase while the number of available deceased donor organs remains relatively constant, the roles of living donor transplantation, adjuvant, and neoadjuvant therapy will continue to evolve.

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Abbreviations

CTP:

Child-turcotte-pugh

HCC:

Hepatocellular carcinoma

MELD:

Model for end-stage liver disease

PEI:

Percutaneous ethanol injection

RFA:

Radiofrequency ablation

SRTR:

Scientific registry of transplant recipients

TACE:

Transarterial chemoembolization

TNM:

Tumor node metastasis

UCLA:

University of California Los Angeles

UCSF:

University of California San Francisco

UNOS/OPTN:

United network for organ sharing/organ procurement and transplant network

VEGF:

Vascular endothelial growth factor

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Author information

Authors and Affiliations

  1. Assistant Professor of Surgery, Division of Abdominal Organ Transplantation, Oregon Health and Science University, 3181 SW Sam Jackson Park Road, L590, Portland, OR, USA

    Truman Mark Earl

  2. Professor of Surgery and Chief, Section of Transplantation, Washington University School of Medicine, 660 S. Euclid Avenue, Campus Box 8109, St Louis, MO, 63130, USA

    William C. Chapman

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Correspondence to William C. Chapman .

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Editors and Affiliations

  1. M.D. Anderson Cancer Center, Dept. Surgical Oncology, University of Texas, Holcombe Blvd. 1515, Houston, 77030, Texas, USA

    Jean-Nicolas Vauthey

  2. , Dept. of Surgical Oncology, MD Anderson Cancer Center, Holcombe Boulevard, Unit 444 1515, Houston, 77030, USA

    Antoine Brouquet

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Earl, T.M., Chapman, W.C. (2013). Transplantation for Hepatocellular Carcinoma: The North American Experience. In: Vauthey, JN., Brouquet, A. (eds) Multidisciplinary Treatment of Hepatocellular Carcinoma. Recent Results in Cancer Research, vol 190. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-16037-0_10

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  • DOI: https://doi.org/10.1007/978-3-642-16037-0_10

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